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MARK A ELLISON LTD NPI 1013967116


NPI Information

NPI: 1013967116
Provider Name: MARK A ELLISON, LTD

Doing Business As: FAMILY VISION CARE OF SOUTHERN ILLINOIS

Classification: Optometrist - 152W00000X
Entity Type: Organization
Address:
422 W BETHALTO DR
BETHALTO, IL
ZIP 62010
Phone: (618) 377-5221
Get Directions

MARK A ELLISON, LTD is an optometrist in Bethalto, IL. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. MARK A ELLISON, LTD NPI is 1013967116. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Family Vision Care Of Southern Illinois.

The provider's business location address is:

422 W BETHALTO DR
BETHALTO, IL
ZIP 62010-700
Phone: (618) 377-5221
Fax: (618) 377-5220

The provider's authorized official is Mark A. Ellison .
The authorized official title is President and has the following contact phone number (618) 635-2424.

The enumeration date for this NPI number is 5/11/2006 and was last updated on 8/21/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1152W00000XOptometrist046007313ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1DH1681MEDICARE PINILLINOIS
20241360001MEDICARE NSCILLINOIS
3976180MEDICARE PINILLINOIS
4T37740MEDICARE UPINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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