NPIMap

Organization Active NPI

Shelle Optical

  • Optometrist
  • South Chicago Heights, IL
National Provider Identifier
1295908663
Registry record updated Apr 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SHELLE OPTICAL
Practice address
170 W Sauk TRL
South Chicago Heights, IL 60411-5359
Phone
(708) 754-7111
NPI assigned
Apr 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2008

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

Authorized official

Name
John Becker
Title
Owner
Phone
(708) 754-7111

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X Primary
OpticianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 156FX1800X

Addresses

Primary practice location

170 W Sauk TRL
South Chicago Heights, IL 60411-5359

Mailing address

170 W Sauk TRL
South Chicago Heights, IL 60411-5359
Phone (708) 754-7111

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1295908663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 W SAUK TRL",
            "city": "SOUTH CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604115359",
            "telephone_number": "708-754-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 W SAUK TRL",
            "city": "SOUTH CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604115359",
            "telephone_number": "708-754-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHELLE OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-754-7111"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Chicago Heights, IL

Sources for this page

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