NPIMap

Organization Active NPI

Midwest Eye Group, P.C.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1356513337
Registry record updated Sep 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
060-009246 Issued in IL
Legal business name
MIDWEST EYE GROUP, P.C.
Practice address
6254 S. Pulaski Road
Chicago, IL 60629
Phone
(773) 581-1515
Fax
(773) 581-9663
NPI assigned
Mar 30, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2010

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

Authorized official

Name
Ms. Dawn Marie Birch, O.D. OPTOMETRIST
Title
President
Phone
(773) 581-1515

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 046008190 IL
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 060-009246 IL Primary

Addresses

Primary practice location

6254 S. Pulaski Road
Chicago, IL 60629

Mailing address

6254 S. Pulaski Road
Chicago, IL 60629
Phone (773) 581-1515

Other names 1

  • Midwest Eye Group Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1206835200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284336000000",
    "number": "1356513337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6254 S. PULASKI ROAD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60629",
            "telephone_number": "773-581-1515",
            "fax_number": "773-581-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6254 S. PULASKI ROAD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60629",
            "telephone_number": "773-581-1515",
            "fax_number": "773-581-9663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST EYE GROUP, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-30",
        "last_updated": "2010-09-13",
        "status": "A",
        "authorized_official_last_name": "BIRCH",
        "authorized_official_first_name": "DAWN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-581-1515",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "O.D. OPTOMETRIST"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008190",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "060-009246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midwest Eye Group",
            "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 Sep 13, 2010; 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.