Organization Active NPI

Serpico Family Eye Care, Inc.

  • Optometrist
  • Vernon Hills, IL
National Provider Identifier
1528559846
Registry record updated May 22, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-009099 Issued in IL
Legal business name
SERPICO FAMILY EYE CARE, INC.
Practice address
6 E Phillip Rd Ste 1110
Vernon Hills, IL 60061-1700
Phone
(847) 816-9996
Fax
(847) 816-3142
NPI assigned
May 22, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2018

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

Authorized official

Name
Dr. Anthony A Serpico, ODNPI 1083741979
Title
Optometrist and Owner
Phone
(847) 924-6452

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 046-009099 IL Primary

Addresses

Primary practice location

6 E Phillip Rd Ste 1110
Vernon Hills, IL 60061-1700

Mailing address

6 E Phillip Rd Ste 1110
Vernon Hills, IL 60061-1700
Phone (847) 816-9996

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180807000890 IL Part B Supplier - Clinic/Group Practice 1456609569 Receives reassigned benefits from 1 practitioner
Practice locations: Vernon Hills, IL

National Provider Directory

National Provider Directory

Locations

6 E Phillip Rd
Ste 1100
Vernon Hills, IL 60061

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": "1526947200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1526947200000",
    "number": "1528559846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 E PHILLIP RD STE 1110",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611700",
            "telephone_number": "847-816-9996",
            "fax_number": "847-816-3142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 E PHILLIP RD STE 1110",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611700",
            "telephone_number": "847-816-9996",
            "fax_number": "847-816-3142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SERPICO FAMILY EYE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-22",
        "last_updated": "2018-05-22",
        "status": "A",
        "authorized_official_last_name": "SERPICO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OPTOMETRIST AND OWNER",
        "authorized_official_telephone_number": "847-924-6452",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernon Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.