Provider Demographics
NPI:1750603965
Name:ALLMOND EYECARE, LLC
Entity type:Organization
Organization Name:ALLMOND EYECARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:CONSTANCE
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALLMOND
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:309-829-0636
Mailing Address - Street 1:2225 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61705-5014
Mailing Address - Country:US
Mailing Address - Phone:309-829-0636
Mailing Address - Fax:309-829-0994
Practice Address - Street 1:2225 W MARKET ST
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61705-5014
Practice Address - Country:US
Practice Address - Phone:309-829-0636
Practice Address - Fax:309-829-0994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-16
Last Update Date:2010-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010207152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty