NPIMap

Organization Active NPI

Advanced Focus Vision Center LTD.

  • Optometrist
  • Channahon, IL
National Provider Identifier
1376677971
Registry record updated May 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-009118 Issued in IL
Legal business name
ADVANCED FOCUS VISION CENTER LTD.
Practice address
24735 W Eames St
Suite 11
Channahon, IL 60410-8705
Phone
(815) 467-0077
Fax
(815) 467-0088
NPI assigned
Mar 15, 2007
Organization subpart
No

National Provider Directory

National Provider Directory

Locations

24735 W Eames St
Unit 11
Channahon, IL 60410
Phone (815) 290-5076

NPPES NPI Registry

Updated by the provider on May 15, 2009

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

Authorized official

Name
Dr. Brian Bouton, O.D.
Title
Optometrist President
Phone
(815) 467-0077

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 046-009118 IL Primary

Addresses

Primary practice location

24735 W Eames St
Suite 11
Channahon, IL 60410-8705

Mailing address

24735 W Eames St
Suite 11
Channahon, IL 60410-8705
Phone (815) 467-0077

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242345600000",
    "number": "1376677971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24735 W EAMES ST",
            "address_2": "SUITE 11",
            "city": "CHANNAHON",
            "state": "IL",
            "postal_code": "604108705",
            "telephone_number": "815-467-0077",
            "fax_number": "815-467-0088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24735 W EAMES ST",
            "address_2": "SUITE 11",
            "city": "CHANNAHON",
            "state": "IL",
            "postal_code": "604108705",
            "telephone_number": "815-467-0077",
            "fax_number": "815-467-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED FOCUS VISION CENTER LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2009-05-15",
        "status": "A",
        "authorized_official_last_name": "BOUTON",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "OPTOMETRIST PRESIDENT",
        "authorized_official_telephone_number": "815-467-0077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Channahon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2009; 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.