BLW Optical, Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

046008205 Issued in IL

Legal business name

BLW OPTICAL, INC

Doing business as

American Vision Center

Practice address

9617 S Western Ave
Chicago, IL 60643-1722

Phone

(708) 425-4350

Fax

(708) 425-4359

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Lonnie Williams, ODNPI 1225045669

Title

Owner

Phone

(708) 425-4350

Specialties & licenses 1

Addresses

Other names 1

• American Vision Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lonnie Lee Williams, OD

  • Optometrist
  • South Holland, IL
  • NPI 1225045669
  Medicare reassignment Authorized official
• Byron Wright, O.D.

  • Optometrist
  • Olympia Fields, IL
  • NPI 1346269941
  NPD

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387238400000",
    "number": "1629175849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9617 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431722",
            "telephone_number": "708-425-4350",
            "fax_number": "708-425-4359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9617 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431722",
            "telephone_number": "708-425-4350",
            "fax_number": "708-425-4359"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLW OPTICAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2013-12-17",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "LONNIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-425-4350",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "American Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Stefanie L Blummer
• Alyssa Blumstein, PA-C
• Kayla Elise Blunt
• Trina Marie Blunt, D.D.S.
• Blvd Enterprises Inc
• Stacy Bly
• Blysss Behavioral Health, PLLC
• Ashley N Blythe, RN
• Jeffrey Blythe, LCSW
• Nicole Michelle Tabatabai Blythe, DNP, PMHNP-BC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2013; 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.