OrganizationActive
Novamed Eye Surgery Center of Maryville, LLC
NPI 1023055696 · Certified Registered Nurse Anesthetist · Maryville, IL
Provider details
- NPI number
- 1023055696
- Entity type
- Organization
- Primary specialty
- Certified Registered Nurse AnesthetistPhysician Assistants & Advanced Practice Nursing Providers
- Parent organization
- Novamed, Inc.
- Organization subpart
- Yes
- Authorized official
- Scott Macomber, Executive Vp and Cfo(312) 780-3234
- License
- 7002132 (IL)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Detailed profile(91/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
12 Maryville Professional Park
Maryville, IL 62062
Phone: (618) 288-7483
Fax: (618) 288-7196
Approximate (ZIP-level) locationGet directions
Mailing address
12 Professional Park Dr
Maryville, IL 62062-5672
Other names (DBA / former)
- Doing business as
- Eyes of Illinois Surgery Center of Maryville
Registry dates
- Enumerated
- 2006-06-01
- Last updated
- 2008-04-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.