NPIMap

Organization Active NPI

Medemaeyecare&Associates PC

  • Optometrist
  • Roselle, IL
National Provider Identifier
1659630721
Registry record updated May 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046008031 Issued in IL
Legal business name
MEDEMAEYECARE&ASSOCIATES PC
Practice address
814 Springfield Dr
Roselle, IL 60172-3435
Phone
(630) 881-3339
Fax
(847) 358-4972
NPI assigned
May 10, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2012

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

Authorized official

Name
Dr. Daniel J Medema, ODNPI 1003849456
Title
President
Phone
(630) 881-3339

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 046008031 IL Primary

Addresses

Primary practice location

814 Springfield Dr
Roselle, IL 60172-3435

Mailing address

814 Springfield Dr
Roselle, IL 60172-3435
Phone (630) 881-3339

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1336608000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336608000000",
    "number": "1659630721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "814 SPRINGFIELD DR",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601723435",
            "telephone_number": "630-881-3339",
            "fax_number": "847-358-4972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "814 SPRINGFIELD DR",
            "city": "ROSELLE",
            "state": "IL",
            "postal_code": "601723435",
            "telephone_number": "630-881-3339",
            "fax_number": "847-358-4972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDEMAEYECARE&ASSOCIATES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-10",
        "last_updated": "2012-05-10",
        "status": "A",
        "authorized_official_last_name": "MEDEMA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-881-3339",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roselle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2012; 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.