Organization Active NPI

Forsite Inc

  • Optometrist
  • Chicago, IL
National Provider Identifier
1194841668
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009780 Issued in IL
Legal business name
FORSITE INC
Practice address
1286 N Milwaukee Ave
Chicago, IL 60622-9319
Phone
(773) 384-1500
Fax
(773) 384-1566
NPI assigned
Mar 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Authorized official

Name
John Stangret
Title
President
Phone
(773) 384-1500

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X 046009780 IL Primary

Addresses

Primary practice location

1286 N Milwaukee Ave
Chicago, IL 60622-9319

Mailing address

1286 N Milwaukee Ave
Chicago, IL 60622-9319
Phone (773) 384-1500

Other identifiers 1

IdentifierTypeStateIssuer
046009780MedicaidIL

National Provider Directory

National Provider Directory

Locations

1286 N Milwaukee Ave
Chicago, IL 60622
Phone (630) 841-6473

1295 N Milwaukee Ave
Chicago, IL 60622

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667260800000",
    "number": "1194841668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1286 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606229319",
            "telephone_number": "773-384-1500",
            "fax_number": "773-384-1566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1286 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606229319",
            "telephone_number": "773-384-1500",
            "fax_number": "773-384-1566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORSITE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A",
        "authorized_official_last_name": "STANGRET",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-384-1500"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009780",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; 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.