NPIMap

Organization Active NPI

Dr. Richard Surowiak Inc

  • Optometrist
  • Crystal Lake, IL
National Provider Identifier
1295032761
Registry record updated Mar 26, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046008545 Issued in IL
Legal business name
DR. RICHARD SUROWIAK INC
Practice address
6219 Northwest Hwy
Crystal Lake, IL 60014-7932
Phone
(815) 459-4017
NPI assigned
Feb 18, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2013

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

Authorized official

Name
Dr. Richard J Surowiak, O.D.
Title
President
Phone
(815) 459-4074

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 046008545 IL Primary

Addresses

Primary practice location

6219 Northwest Hwy
Crystal Lake, IL 60014-7932

Mailing address

6219 Northwest Hwy
Crystal Lake, IL 60014-7932
Phone (815) 459-4017

National Provider Directory

National Provider Directory

Locations

6219 N West Hwy
Crystal Lake, IL 60014
Phone (815) 459-4017

NPI Registry JSON

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

{
    "created_epoch": "1297987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364256000000",
    "number": "1295032761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6219 NORTHWEST HWY",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147932",
            "telephone_number": "815-459-4017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6219 NORTHWEST HWY",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600147932",
            "telephone_number": "815-459-4017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. RICHARD SUROWIAK INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-18",
        "last_updated": "2013-03-26",
        "status": "A",
        "authorized_official_last_name": "SUROWIAK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-459-4074",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008545",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2013; 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.