Jency Elakkatt, S.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-009421 Issued in IL

Legal business name

JENCY ELAKKATT, S.C.

Practice address

1460 Golf Rd
Rolling Meadows, IL 60008-4206

Phone

(847) 734-0450

NPI assigned

Apr 18, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Jency Elakkatt

Title

Optometrist/ President

Phone

(312) 318-4626

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1524009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524009600000",
    "number": "1013404755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "926 W STONEHEDGE DR",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601013159",
            "telephone_number": "312-318-4626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 GOLF RD",
            "city": "ROLLING MEADOWS",
            "state": "IL",
            "postal_code": "600084206",
            "telephone_number": "847-734-0450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JENCY ELAKKATT, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-18",
        "last_updated": "2018-04-18",
        "status": "A",
        "authorized_official_last_name": "ELAKKATT",
        "authorized_official_first_name": "JENCY",
        "authorized_official_title_or_position": "OPTOMETRIST/ PRESIDENT",
        "authorized_official_telephone_number": "312-318-4626",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Rolling Meadows, IL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2018; 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.