Healthcare Provider Details
I. General information
NPI: 1649142076
Provider Name (Legal Business Name): ONEOPTO IL 2 PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/23/2025
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5255 STATE ROUTE 251
PERU IL
61354-1005
US
IV. Provider business mailing address
5255 STATE ROUTE 251
PERU IL
61354-1005
US
V. Phone/Fax
- Phone: 815-224-2700
- Fax: 815-224-1178
- Phone: 815-224-2700
- Fax: 815-224-1178
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152W00000X |
| Taxonomy | Optometrist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
PRISCILLA
PAPPAS
Title or Position: PRESIDENT
Credential:
Phone: 217-877-7900