Wilma, LTD

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

060.005866046.007691 Issued in IL

Legal business name

WILMA, LTD

Doing business as

Pealre

Practice address

904 W North Ave
Melrose Park, IL 60160-1520

Phone

(708) 343-9009

Fax

(708) 343-9012

NPI assigned

Jun 7, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Julie A Andriacchi

Title

Manager/Admin.

Phone

(708) 343-9009

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PEALRE Doing business as

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195084800000",
    "number": "1548463615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601520",
            "telephone_number": "708-343-9009",
            "fax_number": "708-343-9012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601520",
            "telephone_number": "708-343-9009",
            "fax_number": "708-343-9012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILMA, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-11-15",
        "status": "A",
        "authorized_official_last_name": "ANDRIACCHI",
        "authorized_official_first_name": "JULIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MANAGER/ADMIN.",
        "authorized_official_telephone_number": "708-343-9009",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "IL",
            "license": "060.005866046.007691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS MEDICAL SUPPLIES",
            "identifier": "0494080001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEALRE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Eyewear Supplier in Melrose Park, IL
• Providers in Melrose Park, IL by specialty
• Eyewear Supplier in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; 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.