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General NPI Number Information
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NPI Number | 1033069224
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Entity Type | Organization
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Legal Business Name | EYE CARE ASSOCIATES OF IL
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Dates
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Enumeration Date | 01/29/2026
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Last Update Date | 01/29/2026
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Provider Practice Location Address
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Address Line | 102 N HEINLEIN DR
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City | SHELBYVILLE
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State | IL
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Zip | 62565-9050
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Country | US
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Telephone | 866-823-5699
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Fax |
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Provider Business Mailing Address
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Address Line | 3723 GREENVILLE AVE STE 41385
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City | DALLAS
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State | TX
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Zip | 75206-5311
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF RCM
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Name | DAVID DEPPEN
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Credential | OD
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Telephone | 937-539-8057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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