Harold E Davis & Terry Alan Trust Etal
NPI 1265621361ActiveOrganization· Optometrist· Oak Lawn, IL
Optometrist in Oak Lawn, Illinois, registered in NPPES in October 2007. The authorized official on file is Jason Davis, Administrative Asst. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1265621361 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 15, 2007 |
| Last updated in NPPES | Jul 1, 2025 |
| Certified by provider | Jul 1, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Optometrist Primary | 152W00000X | — | — |
| Preferred Provider Organization | 305R00000X | 046004083 | IL |
| Preferred Provider Organization | 305R00000X | 046007173 | IL |
| Preferred Provider Organization | 305R00000X | 046009277 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IL) |
|---|
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