Walter Charles Atkenson Jr., O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

46007555 Issued in IL

Practice address

10550 S Cicero Ave
Oak Lawn, IL 60453-5267

Phone

(708) 499-3911

Fax

(708) 424-5318

NPI assigned

Jan 23, 2007

Last updated

Apr 14, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• JK Optical, Inc

  dba Anerican Vision Centers/Eyeworld

  • Optometrist
  • Oak Lawn, IL
  • NPI 1417130543
  Authorized official Same address or phone

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208131200000",
    "number": "1326192543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10550 S CICERO AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535267",
            "telephone_number": "708-499-3911",
            "fax_number": "708-424-5318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10550 S CICERO AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535267",
            "telephone_number": "708-499-3911",
            "fax_number": "708-424-5318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATKENSON",
        "first_name": "WALTER",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2008-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "46007555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 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.