Michael Menconi, OD. PC.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046010227 Issued in IL

Legal business name

MICHAEL MENCONI, OD. PC.

Practice address

1112 E Railroad St
Ste 1
Sandwich, IL 60548-1894

Phone

(630) 786-2020

Fax

(630) 786-6306

NPI assigned

Dec 5, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Michael William Menconi, O.D.

Title

President

Phone

(630) 608-8287

Specialties & licenses 1

Addresses

Other names 1

• Eyecare Center of Sandwich Doing business as

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

{
    "created_epoch": "1291507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307577600000",
    "number": "1376845800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 E RAILROAD ST",
            "address_2": "STE 1",
            "city": "SANDWICH",
            "state": "IL",
            "postal_code": "605481894",
            "telephone_number": "630-786-2020",
            "fax_number": "630-786-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 E RAILROAD ST",
            "address_2": "STE 1",
            "city": "SANDWICH",
            "state": "IL",
            "postal_code": "605481894",
            "telephone_number": "630-786-2020",
            "fax_number": "630-786-6306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL MENCONI, OD. PC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-05",
        "last_updated": "2011-06-09",
        "status": "A",
        "authorized_official_last_name": "MENCONI",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-608-8287",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010227",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eyecare Center of Sandwich",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mark D Weinhold D D S P C
• Patrick Anthony Markley, B.S. R.PH.
• Richard W Mason, DO
• Nicole M McDonald-Martinez
• Michael William Menconi, O.D.
• Midwest Center for Cancer & Blood, SC
• Nicole Lee Milholland
• Amy K Milz, PT
• Kimberly S Miner, LAC
• Karissa Leeann Monney, MD

• All providers in Sandwich, IL
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 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.