Active NPI
Ryan C Socwell, O.D.
- Optometrist
- Niles, IL
National Provider Identifier
1144459223
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046010320
- Practice address
- 8580 W Dempster St
Niles, IL 60714-1402 - Phone
- (847) 699-8580
- NPI assigned
- Jul 9, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3158-035 | WI | |
| Optometrist | 152W00000X | 046010320 | IL | Primary |
Addresses
Primary practice location
8580 W Dempster St
Niles, IL 60714-1402
Mailing address
8580 Dempster
Niles, IL 60714
Phone (847) 699-8580
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3158 | WI | MD | Chiropractor |
| 3158-035 | WI | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1247097600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1369267200000",
"number": "1144459223",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8580 DEMPSTER",
"city": "NILES",
"state": "IL",
"postal_code": "60714",
"telephone_number": "847-699-8580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8580 W DEMPSTER ST",
"city": "NILES",
"state": "IL",
"postal_code": "607141402",
"telephone_number": "847-699-8580"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOCWELL",
"first_name": "RYAN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-07-09",
"last_updated": "2013-05-23",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "WI",
"license": "3158-035",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046010320",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Niles, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.