Active NPI
Forsite Inc
- Optometrist
- Chicago, IL
National Provider Identifier
1194841668
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046009780
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 046009780 | Medicaid | IL |
National Provider Directory
National Provider DirectoryLocations
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.