Susan M Penner

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

SUSAN M PENNER

Practice address

363 S Randall Rd
Elgin, IL 60123

Phone

(847) 888-1555

Fax

(847) 888-2508

NPI assigned

May 2, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Susan M Penner, O.D.

Title

Owner

Phone

(815) 734-6500

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• ELGIN FAMILY EYE CARE Doing business as

Tax ID family

Elgin Family Eye Care2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Susan M Penner

  • Optometrist
  • Byron, IL
  • NPI 1194917971
  NPD tax ID

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Susan M Penner

  • Optometrist
  • Byron, IL
  • NPI 1194917971
  NPPES parent name

Practitioners 3

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

• Toshio Nakajima, O.D.

  • Optometrist
  • Elgin, IL
  • NPI 1609924745
  NPD (past)
• Ellen Renee Petroczky, O.D.

  • Optometrist
  • Elgin, IL
  • NPI 1992996383
  NPD (past)
• Sylvia Thoman, O.D.

  • Optometrist
  • Rockford, IL
  • NPI 1528110533
  NPD (past)

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1508088683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 S RANDALL RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60123",
            "telephone_number": "847-888-1555",
            "fax_number": "847-888-2508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "363 S RANDALL RD",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60123",
            "telephone_number": "847-888-1555",
            "fax_number": "847-888-2508"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN M PENNER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "PENNER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-734-6500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE SUPPLIER",
            "identifier": "0253870001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC",
            "identifier": "0253870002",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4515286",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELGIN FAMILY EYE CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sundeep Franklin DMD & Daiana Capota DMD PLLC
• Joy L. Sunderlage, D.C., L. AC,, DICCP
• Won Sung, DDS
• Mark Surma
• Arvind Surti, R.PH.
• Savitha Susarla, D.O.
• Viswanatham Susarla, M.D.
• Mirella Susnjar, M.D.
• Denisa Luminita Suteu
• Ezri Sutter, QMHP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 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.