Dr Forecki and Associates, LTD

Primary specialty

Point of ServiceTaxonomy code 305S00000X

License

046-007557 Issued in IL

Legal business name

DR FORECKI AND ASSOCIATES, LTD

Practice address

137 W North Ave
Northlake, IL 60164-2316

Phone

(239) 229-6423

NPI assigned

Jan 16, 2008

Last updated

Jan 1, 2015By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Diane G Forecki, ODNPI 1306004148

Title

Optometrist/President

Phone

(239) 229-6423

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Diane G Forecki, OD

  • Optometrist
  • Northlake, IL
  • NPI 1306004148
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1420070400000",
    "number": "1003092388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13326 ISLAND RD",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339051805",
            "telephone_number": "239-229-6423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "137 W NORTH AVE",
            "city": "NORTHLAKE",
            "state": "IL",
            "postal_code": "601642316",
            "telephone_number": "239-229-6423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR FORECKI AND ASSOCIATES, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-16",
        "last_updated": "2015-01-01",
        "status": "A",
        "authorized_official_last_name": "FORECKI",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OPTOMETRIST/PRESIDENT",
        "authorized_official_telephone_number": "239-229-6423",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "305S00000X",
            "taxonomy_group": "",
            "desc": "Point of Service",
            "state": "IL",
            "license": "046-007557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046007557",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Point of Service in Northlake, IL
• Providers in Northlake, IL by specialty
• Point of Service in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.