Active NPI
Michael James Bowker, OD
- Optometrist
- Oak Park, IL
National Provider Identifier
1164418273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 0466944
- Practice address
- 122 N Oak Park Ave
Oak Park, IL 60301-1304 - Phone
- (708) 524-2020
- Fax
- (708) 524-2022
- NPI assigned
- Sep 23, 2005
- Last updated
- Oct 10, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 0466944 | IL | Primary |
Addresses
Primary practice location
122 N Oak Park Ave
Oak Park, IL 60301-1304
Mailing address
960 S Oak Park Ave
Oak Park, IL 60304-1923
Phone (708) 848-1717
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 |
|---|---|---|---|
| 0466944 | IL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127433600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1539129600000",
"number": "1164418273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "960 S OAK PARK AVE",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603041923",
"telephone_number": "708-848-1717",
"fax_number": "708-848-2396"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "122 N OAK PARK AVE",
"city": "OAK PARK",
"state": "IL",
"postal_code": "603011304",
"telephone_number": "708-524-2020",
"fax_number": "708-524-2022"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOWKER",
"first_name": "MICHAEL",
"middle_name": "JAMES",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-09-23",
"last_updated": "2018-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "0466944",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.