George a Roebuck

Primary specialty

OptometristTaxonomy code 152W00000X

License

046007227 Issued in IL

Legal business name

GEORGE A ROEBUCK

Practice address

113 E Jefferson St
Morris, IL 60450-2101

Phone

(815) 942-1951

Fax

(815) 942-1958

NPI assigned

Nov 30, 2007

Organization subpart

No

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

Authorized official

Name

Dr. George A Roebuck, O.D.

Title

Owner

Phone

(815) 942-1951

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1196380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376524800000",
    "number": "1053593186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 E JEFFERSON ST",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604502101",
            "telephone_number": "815-942-1951",
            "fax_number": "815-942-1958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 E JEFFERSON ST",
            "city": "MORRIS",
            "state": "IL",
            "postal_code": "604502101",
            "telephone_number": "815-942-1951",
            "fax_number": "815-942-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE A ROEBUCK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-30",
        "last_updated": "2013-08-15",
        "status": "A",
        "authorized_official_last_name": "ROEBUCK",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-942-1951",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2013; 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.