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MR. RANDY L LIGHT B.C.O., B.A.D.O.
NPI 1124060074
Technician/Technologist - Ocularist in Peoria, IL

Active since June 12, 2006
1318 W CANDLETREE DR, SUITE 3, PEORIA, IL 61614(309) 676-3663(309) 676-0359 Get Directions Write a Review

NPPES record last updated: July 3, 2009. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Mr. Randy L Light B.c.o., B.a.d.o. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. RANDY L LIGHT B.C.O., B.A.D.O. (NPI 1124060074) is an individual ocularist provider in Peoria, Illinois, licensed in Illinois (203.000116) and active in the NPI registry since June 2006.

NPPES Registry Identity

NPI1124060074
Entity TypeIndividualMale
Primary Taxonomy156FX1700X
Provider Legal NameMR. RANDY L LIGHTCredential: B.C.O., B.A.D.O.
Location Address1318 W CANDLETREE DR, SUITE 3Peoria, IL 61614-8508
Mailing Address1318 W Candletree Dr, Suite 3Peoria, IL 61614-8508 · (309) 676-3663 · Fax (309) 676-0359
Phone(309) 676-3663
Fax(309) 676-0359
Sole ProprietorNo
Enumeration DateJune 12, 2006
Last NPPES UpdateJuly 3, 2009
✔ NPI 1124060074 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyTechnician/Technologist · OcularistEye and Vision Services Providers
Taxonomy Code156FX1700X
License✔ Licensed in IL · 203.000116
Definition
An ocularist is a thoroughly trained professional skilled in the art of fitting, painting, and fabricating custom ocular prostheses. In addition to creating custom ocular prostheses, and providing long-term care through periodic examinations, an ocularist provides the patient with complete instructions on the care and maintenance of their prosthesis.
1318 W CANDLETREE DR, Peoria, IL 61614
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Other Identifiers 4

Medicare ID-Type Unspecified1268070002MO
Medicare NSC1268070001AR
Medicare NSC1268070002MO
Medicare NSC1268070001IL

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. BRIAN R DEGISE DDS, PC
Dentist (Orthodontics and Dentofacial Orthopedics)
1318 W CANDLETREE DR
PEORIA, IL 61614
Peoria County (309) 691-9171
BENJAMIN LEROY LIGHT OCULARIST APPRENTICE
Technician/Technologist (Ocularist)
1318 W CANDLETREE DR, SUITE 3
PEORIA, IL 61614
Peoria County (309) 676-3663
DR. JAMES LYNN DAVIS D.M.D.
Dentist (General Practice)
1318 W CANDLETREE DR, SUITE 2
PEORIA, IL 61614
Peoria County (309) 692-6206
LIGHTS PROSTHETIC EYES INC
Technician/Technologist (Ocularist)
1318 W CANDLETREE DR, STE 3
PEORIA, IL 61614
Peoria County (309) 676-3663

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Randy Light's NPI number?

The NPI number for Randy Light is 1124060074. It was assigned to this individual provider in the NPPES registry on June 12, 2006.

Where is Randy Light located?

Randy Light practices at 1318 W Candletree Dr Suite 3, Peoria, IL 61614. The listed phone number is (309) 676-3663.

What is Randy Light's specialty?

The primary specialty registered for this NPI is Technician/Technologist, specializing in Ocularist, with taxonomy code 156FX1700X.

When was this NPI record last updated?

The NPPES record for Randy Light was last updated on July 3, 2009. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.