Search › Illinois › 152W00000X
Jackson Bennett, O.D
NPI 1316098791 · on the registry since 2007 · sole proprietor
Practice
- Address
- 4530 N Brandywine Dr
Eyeglass World 12
Peoria, IL 61614 - Phone
- (309) 682-5833
- Fax
- (309) 682-5929
- Organisation at this address
- National Vision, Inc.
Inferred from a shared address, not stated in the registry.
Registry record
- Primary taxonomy
- 152W00000X
152W00000X
- Licence states on file
- IL
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2007-07-08
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Illinois