Elgin Family Eye Care LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

ELGIN FAMILY EYE CARE LLC

Practice address

165 S Randall Rd
Elgin, IL 60123-5551

Phone

(847) 888-1555

Fax

(847) 888-2508

NPI assigned

Oct 31, 2018

Last updated

Oct 31, 2018By 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

Susan M Penner, OD

Title

Manager

Phone

(815) 289-6512

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540944000000",
    "number": "1013484674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1648 N SAUK TRL",
            "city": "OREGON",
            "state": "IL",
            "postal_code": "610618978",
            "telephone_number": "815-289-6512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 S RANDALL RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235551",
            "telephone_number": "847-888-1555",
            "fax_number": "847-888-2508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELGIN FAMILY EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-31",
        "last_updated": "2018-10-31",
        "status": "A",
        "authorized_official_last_name": "PENNER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "815-289-6512",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Elgin, IL
• Providers in Elgin, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 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.