Organization Active NPI

Eyemart Inc

  • Eyewear Supplier
  • Streator, IL
National Provider Identifier
1174901326
Registry record updated May 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
1013061795 Issued in IL
Legal business name
EYEMART INC
Practice address
104 E Main St
Streator, IL 61364-2901
Phone
(815) 672-1161
Fax
(815) 672-7581
NPI assigned
May 8, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2015

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

Authorized official

Name
Gayle Ackerman
Title
Owner
Phone
(815) 672-1161

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 1013061795 IL Primary

Addresses

Primary practice location

104 E Main St
Streator, IL 61364-2901

Mailing address

104 E Main St
Streator, IL 61364-2901
Phone (815) 672-1161

National Provider Directory

National Provider Directory

Locations

104 E Main St
Streator, IL 61364
Phone (815) 672-1161

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1431043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1431043200000",
    "number": "1174901326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 E MAIN ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642901",
            "telephone_number": "815-672-1161",
            "fax_number": "815-672-7581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 E MAIN ST",
            "city": "STREATOR",
            "state": "IL",
            "postal_code": "613642901",
            "telephone_number": "815-672-1161",
            "fax_number": "815-672-7581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYEMART INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-08",
        "last_updated": "2015-05-08",
        "status": "A",
        "authorized_official_last_name": "ACKERMAN",
        "authorized_official_first_name": "GAYLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-672-1161"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "IL",
            "license": "1013061795",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Streator, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2015; 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.