Eagle Optical, Inc.

Primary specialty

OpticianTaxonomy code 156FX1800X

License

18038042 Issued in IL

Legal business name

EAGLE OPTICAL, INC.

Practice address

3319 Ridge Rd
Lansing, IL 60438-3111

Phone

(708) 474-1145

Fax

(708) 474-1876

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

Wendy Novak

Title

Vice President

Phone

(708) 474-3500

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Chen-Yu Kuo, O.D.

  • Optometrist
  • Lansing, IL
  • NPI 1669514709
  NPD (past)

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212019200000",
    "number": "1538204516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2755 INDIANA AVE",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604382225",
            "telephone_number": "708-474-3500",
            "fax_number": "708-474-3556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3319 RIDGE RD",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604383111",
            "telephone_number": "708-474-1145",
            "fax_number": "708-474-1876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE OPTICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2008-05-29",
        "status": "A",
        "authorized_official_last_name": "NOVAK",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "708-474-3500"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "IL",
            "license": "18038042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tiffany Dunlap
• Rhiannon Amber Duran, CCC-SLP/L
• Danae Durham
• Timothy K Durnin, D.C.
• Eagle Optical, Inc.
• Maryann Ebom, DNP, PMHNP, FNP
• Donna Edmonson
• Tiffany Gae Edwards
• Elaris Home Care Service LLC
• Elaris Home Services LLC

• Optician in Lansing, IL
• Providers in Lansing, IL by specialty
• Optician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.