NPIMap

Organization Active NPI

Sams Club Optical

  • Eyewear Supplier
  • Gurnee, IL
National Provider Identifier
1124129887
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
SAMS CLUB OPTICAL
Doing business as
Sam's Club Optical 30-8184
Practice address
6570 Grand Ave
Gurnee, IL 60031-1621
Phone
(847) 855-1130
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Linda M. Epperson
Title
Npi Coordinator
Phone
(316) 788-5580

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OpticianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 156FX1800X
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

6570 Grand Ave
Gurnee, IL 60031-1621

Mailing address

702 SW 8TH St
Bentonville, AR 72716-6209

Other names 1

  • Sam's Club Optical 30-8184 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Sam'S Hearing Aid Center 6332819 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 14

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1124129887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727166209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6570 GRAND AVE",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600311621",
            "telephone_number": "847-855-1130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAMS CLUB OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "EPPERSON",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "NPI COORDINATOR",
        "authorized_official_telephone_number": "316-788-5580"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sam's Club Optical 30-8184",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gurnee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.