Provider Demographics
NPI:1114271335
Name:NEMEH EYECARE P.C.
Entity Type:Organization
Organization Name:NEMEH EYECARE P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:G
Authorized Official - Last Name:NEMEH
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:217-663-9009
Mailing Address - Street 1:2610 N PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:CHAMPAIGN
Mailing Address - State:IL
Mailing Address - Zip Code:61822-1251
Mailing Address - Country:US
Mailing Address - Phone:217-352-1812
Mailing Address - Fax:217-403-1769
Practice Address - Street 1:2610 N PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61822-1251
Practice Address - Country:US
Practice Address - Phone:217-352-1812
Practice Address - Fax:217-403-1769
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046009593152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty