Active NPI
P E Warnick, O.D.
- Optometrist
- Crystal Lake, IL
National Provider Identifier
1174738538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046006441
- Practice address
- 4777 Northwest Hwy
Crystal Lake, IL 60014-7340 - Phone
- (847) 867-9029
- NPI assigned
- May 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 046006441 | IL | Primary |
Addresses
Primary practice location
4777 Northwest Hwy
Crystal Lake, IL 60014-7340
Mailing address
4777 Northwest Hwy
Crystal Lake, IL 60014-7340
Phone (984) 786-7902
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 |
|---|---|---|---|
| 046006441 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ziva Optical II, LTD. | Optometrist | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1264032000000",
"number": "1174738538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4777 NORTHWEST HWY",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600147340",
"telephone_number": "984-786-7902"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4777 NORTHWEST HWY",
"city": "CRYSTAL LAKE",
"state": "IL",
"postal_code": "600147340",
"telephone_number": "847-867-9029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WARNICK",
"first_name": "P",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-11",
"last_updated": "2010-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046006441",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Crystal Lake, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.