NPIMap

Organization Active NPI

Optometric Center, PC

  • Optometrist
  • Savanna, IL
National Provider Identifier
1497925754
Registry record updated Nov 10, 2009
On this page

Key facts

NPPES NPI Registry
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
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2009

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

Authorized official

Name
Robert Lee Simmons, OD
Title
Owner
Phone
(815) 273-2422

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 046007403 IL Primary

Addresses

Primary practice location

413 Main St
Savanna, IL 61074-1964

Mailing address

413 Main St
Savanna, IL 61074-1535
Phone (815) 273-2422

National Provider Directory

National Provider Directory

Locations

413 Main St
Savanna, IL 61074
Phone (815) 273-2422

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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": []
}

Other providers in Savanna, IL

Sources for this page

  • 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.