NPIMap

Organization Active NPI

Modern Optical Eyewear, Inc.

  • Eyewear Supplier
  • Chicago, IL
National Provider Identifier
1346384450
Registry record updated Apr 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
License
332H00000X Issued in IL
Legal business name
MODERN OPTICAL EYEWEAR, INC.
Practice address
2812 W Foster Ave
Chicago, IL 60625-3506
Phone
(773) 784-6300
Fax
(773) 360-9589
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2008

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

Authorized official

Name
Mr. John Maniatakis
Title
Owner
Phone
(773) 784-6300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X 332H00000X IL Primary

Addresses

Primary practice location

2812 W Foster Ave
Chicago, IL 60625-3506

Mailing address

2812 W Foster Ave
Chicago, IL 60625-3506
Phone (773) 784-6300

National Provider Directory

National Provider Directory

Locations

2812 W Foster Ave
Chicago, IL 60625
Phone (773) 784-6300

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207526400000",
    "number": "1346384450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2812 W FOSTER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253506",
            "telephone_number": "773-784-6300",
            "fax_number": "773-360-9589"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2812 W FOSTER AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606253506",
            "telephone_number": "773-784-6300",
            "fax_number": "773-360-9589"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN OPTICAL EYEWEAR, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2008-04-07",
        "status": "A",
        "authorized_official_last_name": "MANIATAKIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-784-6300",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "IL",
            "license": "332H00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Apr 7, 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.