Miriam M Weller , O.D., LTD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046008047 Issued in IL

Legal business name

MIRIAM M WELLER , O.D., LTD

Practice address

2900 Patriot Blvd
Glenview, IL 60026-8046

Phone

(847) 730-1006

Fax

(847) 730-1027

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Miriam M Weller, O.D.

Title

President

Phone

(847) 730-1006

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252540800000",
    "number": "1154446706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 PATRIOT BLVD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268046",
            "telephone_number": "847-730-1006",
            "fax_number": "847-730-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 PATRIOT BLVD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600268046",
            "telephone_number": "847-730-1006",
            "fax_number": "847-730-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIRIAM M WELLER , O.D., LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2009-09-10",
        "status": "A",
        "authorized_official_last_name": "WELLER",
        "authorized_official_first_name": "MIRIAM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-730-1006",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008047",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Glenview, IL
• Providers in Glenview, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; 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.