American Crystal Optical

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

261Q00000X Issued in IL

Legal business name

AMERICAN CRYSTAL OPTICAL

Practice address

3752 W Fullerton Ave
Chicago, IL 60647-2331

Phone

(773) 252-5025

Fax

(773) 252-6425

NPI assigned

Sep 24, 2008

Last updated

Sep 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Carmen Zuniga, OWNER

Title

Manager

Phone

(773) 252-5025

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1447400676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3752 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472331",
            "telephone_number": "773-252-5025",
            "fax_number": "773-252-6425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3752 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472331",
            "telephone_number": "773-252-5025",
            "fax_number": "773-252-6425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMERICAN CRYSTAL OPTICAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "ZUNIGA",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-252-5025",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "OWNER"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "261Q00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 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.