Individual provider Active NPI

Roger Allen Sona, O.D

  • Optometrist
  • Antioch, IL
National Provider Identifier
1205954716
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
466689 Issued in IL
Practice address
735 Main St
Antioch, IL 60002-1321
Phone
(847) 395-8885
Fax
(847) 395-8913
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 466689 IL Primary

Addresses

Primary practice location

735 Main St
Antioch, IL 60002-1321

Mailing address

735 Main St
Antioch, IL 60002-1321
Phone (847) 395-8885

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
466689ILMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205954716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 MAIN ST",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021321",
            "telephone_number": "847-395-8885",
            "fax_number": "847-395-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 MAIN ST",
            "city": "ANTIOCH",
            "state": "IL",
            "postal_code": "600021321",
            "telephone_number": "847-395-8885",
            "fax_number": "847-395-8913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONA",
        "first_name": "ROGER",
        "middle_name": "ALLEN",
        "credential": "O.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "466689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Antioch, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.