NPIMap

Organization Active NPI

Ernest I. Watanabe, O.D. LTD.

Doing business as Granville Vision Center

  • Clinic/Center
  • Chicago, IL
National Provider Identifier
1285818120
Registry record updated Sep 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
046006692 Issued in IL
Legal business name
ERNEST I. WATANABE, O.D. LTD.
Doing business as
Granville Vision Center
Practice address
1108 W Granville Ave
Chicago, IL 60660-2013
Phone
(773) 465-6660
Fax
(773) 274-8222
NPI assigned
Dec 27, 2007
Last updated
Sep 9, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2008

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

Authorized official

Name
Dr. Ernest Isamu Watanabe, O.D.NPI 1053488569
Title
President
Phone
(773) 465-6660

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)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 046006692 IL Primary

Addresses

Primary practice location

1108 W Granville Ave
Chicago, IL 60660-2013

Mailing address

1108 W Granville Ave
Chicago, IL 60660-2013
Phone (773) 465-6660

Other identifiers 2

IdentifierTypeStateIssuer
1053488569OtherINDIVIDUAL NPI #
046006692OtherILIL STATE LICENSE

Other names 1

  • Granville Vision Center Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220918400000",
    "number": "1285818120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1108 W GRANVILLE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606602013",
            "telephone_number": "773-465-6660",
            "fax_number": "773-274-8222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1108 W GRANVILLE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606602013",
            "telephone_number": "773-465-6660",
            "fax_number": "773-274-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERNEST I. WATANABE, O.D. LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2008-09-09",
        "status": "A",
        "authorized_official_last_name": "WATANABE",
        "authorized_official_first_name": "ERNEST",
        "authorized_official_middle_name": "ISAMU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-465-6660",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "046006692",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI #",
            "identifier": "1053488569",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL STATE LICENSE",
            "identifier": "046006692",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Granville Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 9, 2008; 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.