MEDICARE: EYECARE OF ILLINOIS LTD

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	046007892	IL

General Provider Information

NPI Number	:	1932207073
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EYECARE OF ILLINOIS LTD

Provider Business Mailing Address
First Line	:	5308 W MAIN ST
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62226-4733
Country	:	US
Telephone Number	:	618-257-9800
Fax Number	:	618-355-7800

Provider Business Practice Location Address
First Line	:	5308 WEST MAIN ST
Second Line	:
City	:	BELLEVILLE
State	:	IL
Zip	:	62226
Country	:	US
Telephone Number	:	618-257-9800
Fax Number	:	618-355-7800

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CRAIG A SIERON
Credential	:	OD
Telephone Number	:	618-257-9800

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	08/07/2025

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