Interstate Optical LBR Inc

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

INTERSTATE OPTICAL LBR INC

Doing business as

marquette vision center

Practice address

9612 Willow LN
Mokena, IL 60448-9318

Phone

(708) 479-6232

NPI assigned

Jun 2, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Gary Lee Stephens

Title

Optician

Phone

(708) 479-6232

Specialties & licenses 1

Addresses

Other names 1

• marquette vision center Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 7

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

• Glenn D. Kueltzo, O.D.

  • Optometrist
  • Homer Glen, IL
  • NPI 1740290386
  Medicare reassignment Care Compare group NPD
• Jeanie C Lucy, OD

  • Optometrist
  • Downers Grove, IL
  • NPI 1578610465
  Medicare reassignment Care Compare group NPD
• Paras Patel, OD

  • Optometrist
  • Villa Park, IL
  • NPI 1134727860
  Medicare reassignment NPD
• Amy Mongyun Wen, OD

  • Optometrist
  • Chicago, IL
  • NPI 1588280218
  Medicare reassignment NPD
• Kristina Dimova, O.D.

  • Optometrist
  • Westerly, RI
  • NPI 1811120538
  NPD (past)
• Melanie A Riley Peters, OD

  • Optometrist
  • Jacksonville, FL
  • NPI 1225021637
  NPD (past)
• Jennifer Lynn Sommer, OD

  • Optometrist
  • Greensburg, PA
  • NPI 1760645147
  NPD (past)

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192752000000",
    "number": "1114965126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9612 WILLOW LN",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604489318",
            "telephone_number": "708-479-6232"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9612 WILLOW LN",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604489318",
            "telephone_number": "708-479-6232"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERSTATE OPTICAL LBR INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2007-10-19",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OPTICIAN",
        "authorized_official_telephone_number": "708-479-6232",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "marquette vision center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Illinois Glaucoma Center, LTD
• Sharyn L Ingrum, PSY.D
• Innovative Medical Consulting
• Inspire Behavioral Solutions LLC
• Instarx Pharmacy LLC
• Ipa of Kane County
• Mary Donna Iverson
• J & Medical Transportation
• Cheryl Lynn Jackson, RDCS
• Mohamad Jalab, RSA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.