Idoc Inc.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046009094 Issued in IL

Legal business name

IDOC INC.

Doing business as

Chicago Eye Center

Practice address

4113 Saint Charles Rd
Bellwood, IL 60104-1145

Phone

(708) 493-9306

Fax

(708) 493-0144

NPI assigned

May 29, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Erwin P. Cabela, O.D.NPI 1992710578

Title

Doctor of Optometry- President

Phone

(708) 369-7346

Specialties & licenses 1

Addresses

Other names 1

• Chicago Eye Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Erwin Cabela, O.D.

  • Optometrist
  • Bellwood, IL
  • NPI 1992710578
  Medicare reassignment NPD Authorized official
• Richard Joseph Surowiak, O.D.

  • Optometrist
  • Crystal Lake, IL
  • NPI 1811040983
  NPD (past)

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190851200000",
    "number": "1255532248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4113 SAINT CHARLES RD",
            "city": "BELLWOOD",
            "state": "IL",
            "postal_code": "601041145",
            "telephone_number": "708-493-9306",
            "fax_number": "708-493-0144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4113 SAINT CHARLES RD",
            "city": "BELLWOOD",
            "state": "IL",
            "postal_code": "601041145",
            "telephone_number": "708-493-9306",
            "fax_number": "708-493-0144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDOC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-29",
        "last_updated": "2007-09-27",
        "status": "A",
        "authorized_official_last_name": "CABELA",
        "authorized_official_first_name": "ERWIN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "DOCTOR OF OPTOMETRY- PRESIDENT",
        "authorized_official_telephone_number": "708-369-7346",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009094",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chicago Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marneshia Hiner
• Hiram Kirkendall
• Jasmin Hugle
• Human Corps, Inc.
• Jamilia Humphrey, LSW, MSW
• Malonda Jackson
• Summer Jackson, NP
• Frederick Jefferson, LPC, CADC
• Brandon C John, PA-C
• Carrie Johnson, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.