NPIMap

Organization Active NPI

Thaddeus

  • Eyewear Supplier
  • Chicago, IL
National Provider Identifier
1336331909
Registry record updated Oct 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
THADDEUS
Doing business as
Pearle Vision
Practice address
4812 N. Milwaukee
Chicago, IL 60646
Phone
(773) 545-2660
NPI assigned
Aug 16, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2007

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

Authorized official

Name
Mr. Spencer P Vidulich, O.D.
Title
Owner
Phone
(773) 327-3000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

4812 N. Milwaukee
Chicago, IL 60646

Mailing address

4812 N. Milwaukee
Chicago, IL 60646
Phone (773) 545-2660

Other names 1

  • Pearle Vision Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Thaddeus LTD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191456000000",
    "number": "1336331909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4812 N. MILWAUKEE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60646",
            "telephone_number": "773-545-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4812 N. MILWAUKEE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60646",
            "telephone_number": "773-545-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THADDEUS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-16",
        "last_updated": "2007-10-04",
        "status": "A",
        "authorized_official_last_name": "VIDULICH",
        "authorized_official_first_name": "SPENCER",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-327-3000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision",
            "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 Oct 4, 2007; 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.