Provider Demographics
NPI:1295778587
Name:JFJ EYECARE LTD
Entity type:Organization
Organization Name:JFJ EYECARE LTD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:BART
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:618-277-1130
Mailing Address - Street 1:111 W LINCOLN ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62220-2019
Mailing Address - Country:US
Mailing Address - Phone:618-277-1130
Mailing Address - Fax:618-277-6651
Practice Address - Street 1:3990 N ILLINOIS
Practice Address - Street 2:
Practice Address - City:SWANSEA
Practice Address - State:IL
Practice Address - Zip Code:62226
Practice Address - Country:US
Practice Address - Phone:636-200-4393
Practice Address - Fax:618-277-6651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-14
Last Update Date:2019-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4669520006Medicare NSC
IL4669520001Medicare NSC
IL4669520005Medicare NSC
IL4669520007Medicare NSC
IL4669520003Medicare NSC
IL203195Medicare PIN
IL4669520004Medicare NSC
IL203194Medicare PIN
IL203193Medicare PIN
IL4669520002Medicare NSC