NPIMap

Organization Active NPI

Industrial Optical Service, Inc.

Doing business as Keno Optical

  • Optometrist
  • Chicago, IL
National Provider Identifier
1396895421
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
INDUSTRIAL OPTICAL SERVICE, INC.
Doing business as
Keno Optical
Practice address
29 E Madison St
Suite 808
Chicago, IL 60602-4404
Phone
(773) 736-6800
NPI assigned
Jan 11, 2007
Last updated
May 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Authorized official

Name
Daniel Lieberman, O.D.NPI 1508979741
Title
Optometrist
Phone
(773) 736-6800

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

29 E Madison St
Suite 808
Chicago, IL 60602-4404

Mailing address

4418 W Diversey Ave
Chicago, IL 60639-1924
Phone (773) 736-6800

Other identifiers 2

IdentifierTypeStateIssuer
7235044OtherILAETNA
1636706OtherILBCBS

Other names 1

  • Keno Optical Doing business as

National Provider Directory

National Provider Directory

Locations

29 E Madison St
Ste 808
Chicago, IL 60602
Phone (312) 782-4208

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1396895421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4418 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391924",
            "telephone_number": "773-736-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 E MADISON ST",
            "address_2": "SUITE 808",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606024404",
            "telephone_number": "773-736-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDUSTRIAL OPTICAL SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "LIEBERMAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "773-736-6800",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7235044",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1636706",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Keno Optical",
            "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 May 15, 2008; 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.