Individual provider Active NPI

Walter Charles Atkenson Jr., O.D.

  • Optometrist
  • Oak Lawn, IL
National Provider Identifier
1326192543
Registry record updated Apr 14, 2008
On this page

Key facts

NPPES NPI Registry
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
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 46007555 IL Primary

Addresses

Primary practice location

10550 S Cicero Ave
Oak Lawn, IL 60453-5267

Mailing address

10550 S Cicero Ave
Oak Lawn, IL 60453-5267
Phone (708) 499-3911

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46007555ILMDOptometrist

NPI Registry JSON

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": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • 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.