ShopKo Optical 174 – Eyewear Supplier, NPI 1073565180

ShopKo Optical 174 is a healthcare provider. based in Peoria, Illinois. specializing in Eyewear Supplier. The NPI Number for ShopKo Optical 174 is 1073565180

Main info

Organization
Name
ShopKo Optical 174
NPI
1073565180
Phone
(309) 691-4815
Address
2323 W PIONEER PKWY
Authorized Official
MICHAEL J BETTIGA SR. VICE PRESIDENT HEALTH SERVICES RPH
Enumeration Date
17 May 2006
Last Update Date
28 September 2007
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness80
Years active:20State licenses:0Digital endpointsUpdated within 12 months

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Provider Addresses for ShopKo Optical 174

  • 2323, West Pioneer Parkway, Peoria, Peoria County, Illinois, 61615, United States

    PEORIA, IL 616151833

    Phone: (309) 691-4815

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 61615)

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Reviews

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Frequently asked questions

Is ShopKo Optical 174 listed with a National Provider Identifier?
Yes — ShopKo Optical 174 has NPI 1073565180 on file in the registry.
Would ShopKo Optical 174 appear as active to a payer?
You can treat ShopKo Optical 174 as active for directory purposes; confirm clinical privileges separately.
What kind of doctor is ShopKo Optical 174?
ShopKo Optical 174 is associated with Eyewear Supplier in the directory — Clinical services aligned with this taxonomy classification.
What locale is associated with ShopKo Optical 174?
Directory geography for ShopKo Optical 174 centers on Peoria, Illinois.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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