NPIMap

Organization Active NPI

Dr Dawn Wickizer and Associates LLC

  • Optometrist
  • Algonquin, IL
National Provider Identifier
1003290560
Registry record updated Jul 15, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009347 Issued in IL
Legal business name
DR DAWN WICKIZER AND ASSOCIATES LLC
Practice address
436 S Randall Rd
Algonquin, IL 60102-9723
Phone
(847) 658-4242
Fax
(847) 658-5643
NPI assigned
Jul 15, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2015

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

Authorized official

Name
Dr. Dawn Wickizer, O.D.
Title
Owner
Phone
(847) 658-4242

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 046009347 IL Primary

Addresses

Primary practice location

436 S Randall Rd
Algonquin, IL 60102-9723

Mailing address

436 S Randall Rd
Algonquin, IL 60102-9723
Phone (847) 658-4242

Other names 1

  • Dawn Wickizer Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1436918400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436918400000",
    "number": "1003290560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "436 S RANDALL RD",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601029723",
            "telephone_number": "847-658-4242",
            "fax_number": "847-658-5643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "436 S RANDALL RD",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601029723",
            "telephone_number": "847-658-4242",
            "fax_number": "847-658-5643"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR DAWN WICKIZER AND ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-15",
        "last_updated": "2015-07-15",
        "status": "A",
        "authorized_official_last_name": "WICKIZER",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-658-4242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dawn Wickizer",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Algonquin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.