Daniel Joseph Jannotta, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046007100 Issued in IL

Practice address

4306D W Crystal Lake Rd
McHenry, IL 60050

Phone

(815) 385-7930

Fax

(815) 385-9234

NPI assigned

Sep 15, 2006

Last updated

Mar 16, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• DRS. Peterson & Jannotta Optometrists PC

  • Optometrist
  • McHenry, IL
  • NPI 1972708790
  Authorized official Same address or phone

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1568568186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9795 CROSSPOINT BLVD",
            "address_2": "STE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462563348",
            "telephone_number": "317-254-6480",
            "fax_number": "317-259-8609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4306D W CRYSTAL LAKE RD",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "60050",
            "telephone_number": "815-385-7930",
            "fax_number": "815-385-9234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANNOTTA",
        "first_name": "DANIEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CORP TAX ID",
            "identifier": "363408484",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "05632150",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046007100",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James a Lovell Federal Health Care Center
• Damaine Horace James Sr.
• Nadia Jamison
• Lorrie Janeczko
• Bhairvi Jani, MD
• Holly Jarovsky, P.T.
• Ahmad Jarrar, MD
• Dennis Jasieniecki, CRNA
• Rebecca Jaster
• Muhammad Saeed Javed, M.D

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; 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.