Optical Outlet of Belvider

Primary specialty

OpticianTaxonomy code 156FX1800X

Legal business name

OPTICAL OUTLET OF BELVIDER

Practice address

2026 N State St # H
Belvidere, IL 61008-1957

Phone

(815) 312-3195

Fax

(866) 441-1133

NPI assigned

Jan 27, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Jose L Nieves

Title

Owner

Phone

(815) 397-5940

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1296086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296086400000",
    "number": "1346546140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2026 N STATE ST # H",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610081957",
            "telephone_number": "815-312-3195",
            "fax_number": "866-441-1133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2026 N STATE ST # H",
            "city": "BELVIDERE",
            "state": "IL",
            "postal_code": "610081957",
            "telephone_number": "815-312-3195",
            "fax_number": "866-441-1133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICAL OUTLET OF BELVIDER",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-27",
        "last_updated": "2011-01-27",
        "status": "A",
        "authorized_official_last_name": "NIEVES",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-397-5940",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Optician in Belvidere, IL
• Providers in Belvidere, IL by specialty
• Optician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; 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.