Active NPI
Susan M Penner
Doing business as Eyecare Dimensions
- Optometrist
- Byron, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- Legal business name
- SUSAN M PENNER
- Doing business as
- Eyecare Dimensions
- Practice address
- 134 E Blackhawk Dr
Byron, IL 61010-8610 - Phone
- (815) 234-2020
- Fax
- (815) 234-7070
- NPI assigned
- Aug 15, 2007
- Last updated
- Aug 15, 2007
- Organization subpart
- Yes
- Parent organization
- SUSAN M PENNER
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Susan M Penner, O.D.
- Title
- Owner
- Phone
- (815) 234-2020
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | IL | Primary |
Addresses
Primary practice location
134 E Blackhawk Dr
Byron, IL 61010-8610
Mailing address
134 E Blackhawk Dr
Byron, IL 61010-8610
Phone (815) 234-2020
Other names 1
- EYECARE DIMENSIONS
National Provider Directory
National Provider Directory- Tax ID family
- Elgin Family Eye Care
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
Locations
134 E Blackhawk Dr
Byron, IL 61010
Phone (815) 234-2020
Ownership & related parties
Parent organization (reported in NPPES) 1
This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Optometrist
- Byron, IL
- NPI 1891842464
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187136000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1187136000000",
"number": "1194917971",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "134 E BLACKHAWK DR",
"city": "BYRON",
"state": "IL",
"postal_code": "610108610",
"telephone_number": "815-234-2020",
"fax_number": "815-234-7070"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "134 E BLACKHAWK DR",
"city": "BYRON",
"state": "IL",
"postal_code": "610108610",
"telephone_number": "815-234-2020",
"fax_number": "815-234-7070"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUSAN M PENNER",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "SUSAN M PENNER",
"enumeration_date": "2007-08-15",
"last_updated": "2007-08-15",
"status": "A",
"authorized_official_last_name": "PENNER",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "815-234-2020",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "O.D."
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "EYECARE DIMENSIONS",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Byron, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.