MEDICARE: DR. JAMEY C WARE O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	046009522	IL

General Provider Information

NPI Number	:	1205833225
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMEY C WARE O.D.

Provider Business Mailing Address
First Line	:	2929 MCFARLAND RD
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61107-6809
Country	:	US
Telephone Number	:	815-654-2020
Fax Number	:	815-654-0393

Provider Business Practice Location Address
First Line	:	2929 MCFARLAND RD
Second Line	:
City	:	ROCKFORD
State	:	IL
Zip	:	61107-6809
Country	:	US
Telephone Number	:	815-654-2020
Fax Number	:	815-654-0393

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	04/06/2026

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