Wendy'S Eyeglass Shack, Inc.

Primary specialty

OpticianTaxonomy code 156FX1800X

License

136295 Issued in IL

Legal business name

WENDY'S EYEGLASS SHACK, INC.

Practice address

8424 N Knoxville Ave
Peoria, IL 61615-2032

Phone

(309) 693-0100

NPI assigned

Jul 24, 2008

Organization subpart

No

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

Authorized official

Name

Wendy Ruth SmithNPI 1770761306

Title

Certified Optician

Phone

(309) 693-0100

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Wendy Smith

  • Optician
  • Peoria, IL
  • NPI 1770761306
  NPD (past) Authorized official

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

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285027200000",
    "number": "1104081587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8424 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152032",
            "telephone_number": "309-693-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8424 N KNOXVILLE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616152032",
            "telephone_number": "309-693-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WENDY'S EYEGLASS SHACK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-24",
        "last_updated": "2010-09-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "WENDY",
        "authorized_official_middle_name": "RUTH",
        "authorized_official_title_or_position": "CERTIFIED OPTICIAN",
        "authorized_official_telephone_number": "309-693-0100"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "IL",
            "license": "136295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naomi Wells, PHARM.D.
• Rachel L Wells, SPEECH/LANG PATH
• Taylor Marie Wells, MD
• Maureen Welty, DNP
• Abigail V. Welu, DO
• Jamie Wernsman, PH.D.
• Carly Nicole Wertz, CARLY
• Genevieve Elizabeth Wessel, AGACNP, APN, CNP
• West Central Allergy Center S.C.
• Roberta West, LCSW

• Optician in Peoria, IL
• Providers in Peoria, IL by specialty
• Optician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; 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.