Plainfield Vision Center LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

046009646 Issued in IL

Legal business name

PLAINFIELD VISION CENTER LLC

Practice address

5501 W Plainfield Rd
Countryside, IL 60525-3591

Phone

(708) 482-7744

NPI assigned

Apr 30, 2011

Last updated

Apr 30, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ketan Sheladia, O.D.NPI 1982746848

Title

President

Phone

(708) 482-7744

Specialties & licenses 1

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ketan K Sheladia, O.D.

  • Optometrist
  • Chicago, IL
  • NPI 1982746848
  NPD (past) Authorized official
• Carly Szafranski, OD

  • Optometrist
  • Countryside, IL
  • NPI 1437341047
  NPD (past)

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

{
    "created_epoch": "1304121600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304121600000",
    "number": "1194016717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5501 W PLAINFIELD RD",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605253591",
            "telephone_number": "708-482-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5501 W PLAINFIELD RD",
            "city": "COUNTRYSIDE",
            "state": "IL",
            "postal_code": "605253591",
            "telephone_number": "708-482-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLAINFIELD VISION CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-30",
        "last_updated": "2011-04-30",
        "status": "A",
        "authorized_official_last_name": "SHELADIA",
        "authorized_official_first_name": "KETAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-482-7744",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Countryside, IL
• Providers in Countryside, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2011; 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.