Dekalb Optical Shop LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DEKALB OPTICAL SHOP LLC

Doing business as

Hauser-Ross Optical

Practice address

2240 Gateway Dr
Sycamore, IL 60178-3103

Phone

(815) 756-5897

Fax

(815) 756-6263

NPI assigned

Apr 23, 2013

Organization subpart

No

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

Authorized official

Name

George L Neal

Title

Chief Executive Officer

Phone

(469) 214-0144

Specialties & licenses 1

Addresses

Other names 1

• Hauser-Ross Optical Doing business as

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

{
    "created_epoch": "1366675200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1598109456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2240 GATEWAY DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783103",
            "telephone_number": "815-756-5897",
            "fax_number": "815-756-6263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2240 GATEWAY DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783103",
            "telephone_number": "815-756-5897",
            "fax_number": "815-756-6263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB OPTICAL SHOP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-23",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "469-214-0144"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Hauser-Ross Optical",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Hauser-Ross Optical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dekalb Clinic Chartered
• Dekalb Clinic Chartered
• Dekalb Eye Consultants, LLC (Arlington Eye Physicians)
• Dekalb Hearing Services, LLC (Hauser-Ross Hearing Services)
• Dekalb Medical Clinic,Inc (Dekalb Internal Medicine)
• Dekalb Surgical Services, LLC
• Geraldine Maniago Delos Santos, D.O.
• Thomas Dennison, M.D.
• Dental Professionals of Illinois, P.C. (Family Dental Care of Sycamore)
• Millicent Derro, DPT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2020; 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.