Active NPI
Eyemart Inc
- Eyewear Supplier
- Streator, IL
National Provider Identifier
1174901326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Eyewear Supplier
- License
- 1013061795
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 DirectoryLocations
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.
-
- Optometrist
- Rockford, IL
- NPI 1134271190
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.