Active NPI
Patrick Takata
- Optician
- Wilmette, IL
National Provider Identifier
1073947016
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- Practice address
- 120 Skokie Blvd
Wilmette, IL 60091-3050 - Phone
- (847) 251-3330
- Fax
- (847) 251-9580
- NPI assigned
- Aug 27, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | Primary |
Addresses
Primary practice location
120 Skokie Blvd
Wilmette, IL 60091-3050
Mailing address
120 Skokie Blvd
Wilmette, IL 60091-3050
Phone (847) 251-3330
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1377561600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1377561600000",
"number": "1073947016",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 SKOKIE BLVD",
"city": "WILMETTE",
"state": "IL",
"postal_code": "600913050",
"telephone_number": "847-251-3330",
"fax_number": "847-251-9580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 SKOKIE BLVD",
"city": "WILMETTE",
"state": "IL",
"postal_code": "600913050",
"telephone_number": "847-251-3330",
"fax_number": "847-251-9580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAKATA",
"first_name": "PATRICK",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-08-27",
"last_updated": "2013-08-27",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmette, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 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.