Foreman & Stack OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

046007804 Issued in IL

Legal business name

FOREMAN & STACK OD PC

Practice address

876 Roosevelt Rd
Glen Ellyn, IL 60137

Phone

(630) 469-2418

Fax

(630) 469-4680

NPI assigned

Oct 16, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Catherine Mary Stack, OD

Title

Owner Optometrist

Phone

(630) 469-2418

Specialties & licenses 3

Addresses

Locations

Practitioners 1

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

• Paul A Foreman, O.D.

  • Optometrist
  • Chicago, IL
  • NPI 1356310841
  NPD (past)

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

{
    "created_epoch": "1192492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297814400000",
    "number": "1083803050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "876 ROOSEVELT RD",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "60137",
            "telephone_number": "630-469-2418",
            "fax_number": "630-469-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "876 ROOSEVELT RD",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "60137",
            "telephone_number": "630-469-2418",
            "fax_number": "630-469-4680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREMAN & STACK OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-16",
        "last_updated": "2011-02-16",
        "status": "A",
        "authorized_official_last_name": "STACK",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "OWNER OPTOMETRIST",
        "authorized_official_telephone_number": "630-469-2418",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IA",
            "license": "046007804",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007804",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007738",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Douglas R. Finlayson, MD
• Julie Fischer
• Colin James Fisher
• Katrina Mary Flesvig, LCPC
• Thomas Folliard, PT, DPT
• Marcia Gleaves Forrest, LCPC, LMFT
• Tammy Lynn Foster, LCPC
• Ashley Ann Frank Slott, PSY.D., CADC
• Catherine Frederickson
• Jordan Frees

• Optometrist in Glen Ellyn, IL
• Providers in Glen Ellyn, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2011; 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.