Jak Enterprises Dba Jak Optical Laboratories

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

Legal business name

JAK ENTERPRISES DBA JAK OPTICAL LABORATORIES

Practice address

8309 N Knoxville Ave
Peoria, IL 61615-2170

Phone

(800) 654-2833

Fax

(800) 322-1822

NPI assigned

Dec 6, 2016

Organization subpart

No

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

Authorized official

Name

Diana J Hall

Title

President

Phone

(309) 693-9540

Specialties & licenses 1

Addresses

Other names 1

• JAK Optical Laboratories Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Zahra Tahir, OD

  • Optometrist
  • Peoria, IL
  • NPI 1396411195
  NPD

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

{
    "created_epoch": "1480982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1480982400000",
    "number": "1083158372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3333",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616123333",
            "telephone_number": "309-713-1762",
            "fax_number": "309-966-0922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8309 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152170",
            "telephone_number": "800-654-2833",
            "fax_number": "800-322-1822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAK ENTERPRISES DBA JAK OPTICAL LABORATORIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-06",
        "last_updated": "2016-12-06",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "DIANA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-693-9540"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JAK Optical Laboratories",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Asim K Jaffer, MD
• Nazish Hasan Jafri, D.D.S.
• Sarath Kumar Jaganathan Jaishankar, MD
• Matthew D Jager, D.O.
• Jaimee York LLC
• Charlotte Sunaina Jakkula
• Ahmed Tejan Jalloh Jr., MD
• Lynne Marie Jalovec, M.D.
• James J Malavolti DC LLC
• James K Crane MDSC

• Eyewear Supplier in Peoria, IL
• Providers in Peoria, IL by specialty
• Eyewear Supplier in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2016; 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.