Optometric Center, PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

046007403 Issued in IL

Legal business name

OPTOMETRIC CENTER, PC

Practice address

413 Main St
Savanna, IL 61074-1964

Phone

(815) 273-2422

Fax

(815) 273-5034

NPI assigned

Mar 3, 2008

Last updated

Nov 10, 2009By 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

Robert Lee Simmons, ODNPI 1184676967

Title

Owner

Phone

(815) 273-2422

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Robert Lee Simmons, OD

  • Optometrist
  • Savanna, IL
  • NPI 1184676967
  Authorized official Same address or phone
• Sarah A Machala, O.D.

  • Optometrist
  • Galena, IL
  • NPI 1407934961
  NPD (past)

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

{
    "created_epoch": "1204502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257811200000",
    "number": "1497925754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 MAIN ST",
            "city": "SAVANNA",
            "state": "IL",
            "postal_code": "610741535",
            "telephone_number": "815-273-2422",
            "fax_number": "815-273-5034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 MAIN ST",
            "city": "SAVANNA",
            "state": "IL",
            "postal_code": "610741964",
            "telephone_number": "815-273-2422",
            "fax_number": "815-273-5034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTOMETRIC CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-03",
        "last_updated": "2009-11-10",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-273-2422",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Ming Kao, D.C.
• Keith Ruter LLC Dba Riverside Dental
• Richard Joseph Keppler, CRNA
• Ryann Koett
• Randall Morthland
• Pinnacle Health Services, Inc.
• Riverside Dental, PC
• Savanna Community Ambulance Association
• Dhwanil Shah
• Shopko Stores Operating Co LLC (Shopko Pharmacy 635)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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.