Individual provider Active NPI

James A Farlik, O.D.

  • Optometrist
  • Canton, IL
National Provider Identifier
1184631699
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046006720 Issued in IL
Practice address
130 N Main St
Canton, IL 61520-2530
Phone
(309) 647-3396
Fax
(309) 647-8119
NPI assigned
Aug 1, 2006
Last updated
Apr 18, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046006720 IL Primary

Addresses

Primary practice location

130 N Main St
Canton, IL 61520-2530

Mailing address

130 N Main St
Canton, IL 61520-2530
Phone (309) 647-3396

Other identifiers 2

IdentifierTypeStateIssuer
0003784001OtherILBCBS OF IL
046006720MedicaidIL

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

LicenseStateTypeSpecialty
046006720ILMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208476800000",
    "number": "1184631699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 N MAIN ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202530",
            "telephone_number": "309-647-3396",
            "fax_number": "309-647-8119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 N MAIN ST",
            "city": "CANTON",
            "state": "IL",
            "postal_code": "615202530",
            "telephone_number": "309-647-3396",
            "fax_number": "309-647-8119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARLIK",
        "first_name": "JAMES",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2008-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046006720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "0003784001",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046006720",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2008; 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.