Harvey Mack, OD

Primary specialty

OptometristTaxonomy code 152W00000X

Practice address

2020 W Iles Ave
Springfield, IL 62704-4174

Phone

(217) 698-3030

Fax

(217) 698-3068

NPI assigned

May 5, 2006

Last updated

Sep 4, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1386692630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 W ILES AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044174",
            "telephone_number": "217-698-3030",
            "fax_number": "217-698-3068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 W ILES AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044174",
            "telephone_number": "217-698-3030",
            "fax_number": "217-698-3068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "HARVEY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-05",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00315313",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick Macauley, D.C.
• Ashley Patricia Macdonald, D.O.
• Paul C. Mach, DN
• Bette A. Macintosh, MD
• Angell Mack, LCPC
• Barbara L Mackey-Bruzetti, L.C.S.W.
• Erin Mackinney, MD
• Brodie Mackintosh, MD
• Audriahna C Macklin
• Meleah Hope Macneille-Pedersen

• Optometrist in Springfield, IL
• Providers in Springfield, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; 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.