Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JAY CHARLES BLACK, OD
ActiveDR. JAY CHARLES BLACK, OD is a Optometrist healthcare provider located in LOVES PARK, Illinois. NPI 1629113261 is currently active in the NPPES registry. Verify at CMS.
Optometrist · LOVES PARK, IL
Registration Details
- NPI Number
- 1629113261
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 21, 2007 (19.450675287188 yrs)
- Last Updated
- Jul 8, 2007
- License
-
466709 (IL)
Practice Information
- Address
-
5316 N SECOND STREETLOVES PARK, IL, 611115009Browse IL providers · Browse ZIP 61111
- Phone
- 8158776551
- Fax
- 8158774821
- Primary Specialty
-
Optometrist
152W00000X
Other Optometrist Providers in LOVES PARK, IL
| Name | Credential | NPI |
|---|---|---|
| DR. DONALD E WIGHT | O.D. | 1043260144 |
| DR. ROGER H HILL | OD | 1235212275 |
| DR. RICHARD EVANS ANDERSON | OD | 1437232477 |
| DR. JEFFREY ALLAN DANNATT | OD | 1225207558 |
| JENNIFER DUNGAN | OD | 1427212513 |
| ERIC MARNUL | — | 1740617570 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.