Organization Active NPI

Rasa Tamulavichus OD PC

  • Optometrist
  • Evergreen Park, IL
National Provider Identifier
1629267976
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
RASA TAMULAVICHUS OD PC
Practice address
2500 W 95TH St
Walmart Vision Center
Evergreen Park, IL 60805-2807
Phone
(708) 229-0946
NPI assigned
Oct 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Authorized official

Name
Dr. Rasa Tamulavichus, OD
Title
Owner
Phone
(312) 550-7034

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X IL Primary

Addresses

Primary practice location

2500 W 95TH St
Walmart Vision Center
Evergreen Park, IL 60805-2807

Mailing address

912 N Hermitage Ave Unit 3
Chicago, IL 60622-5002
Phone (312) 550-7034

Other names 1

  • rasa tamulavichus Other name

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1629267976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "912 N HERMITAGE AVE UNIT 3",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225002",
            "telephone_number": "312-550-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 W 95TH ST",
            "address_2": "WALMART VISION CENTER",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052807",
            "telephone_number": "708-229-0946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RASA TAMULAVICHUS OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "TAMULAVICHUS",
        "authorized_official_first_name": "RASA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-550-7034",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "rasa tamulavichus",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Evergreen Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.