Chris Martin II OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

046009427 Issued in IL

Legal business name

CHRIS MARTIN II OD PC

Practice address

2080 N. State RT 50
Bourbonnais, IL 60915

Phone

(815) 929-0429

Fax

(815) 929-0530

NPI assigned

Aug 4, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Chris D Martin II, O.D.

Title

President

Phone

(815) 929-0429

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218758400000",
    "number": "1427066232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 N. STATE RT 20",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "60915",
            "telephone_number": "815-929-0429",
            "fax_number": "815-929-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 N. STATE RT 50",
            "city": "BOURBONNAIS",
            "state": "IL",
            "postal_code": "60915",
            "telephone_number": "815-929-0429",
            "fax_number": "815-929-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRIS MARTIN II OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2008-08-15",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-929-0429",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009427",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

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