Park Hills Optical Co

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

IBT#1542-9199 Issued in IL

Legal business name

PARK HILLS OPTICAL CO

Practice address

1110 S Park Blvd
Freeport, IL 61032-4659

Phone

(815) 235-8083

Fax

(815) 232-3117

NPI assigned

Oct 11, 2007

Organization subpart

No

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

Authorized official

Name

Jeffrey James, O.D.

Title

Treasurer/Owner

Phone

(815) 235-8083

Specialties & licenses 1

Addresses

Other identifiers 4

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

{
    "created_epoch": "1192060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1669660932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 S PARK BLVD",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610324659",
            "telephone_number": "815-235-8083",
            "fax_number": "815-232-3117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 S PARK BLVD",
            "city": "FREEPORT",
            "state": "IL",
            "postal_code": "610324659",
            "telephone_number": "815-235-8083",
            "fax_number": "815-232-3117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARK HILLS OPTICAL CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-11",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "JAMES",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "TREASURER/OWNER",
        "authorized_official_telephone_number": "815-235-8083",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "IBT#1542-9199",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1285635722",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1184682635",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1437134509",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMERC PROVIDER",
            "identifier": "0442650001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joseph Rudolph Pale, MD
• Sarah Palmquist
• Alexander Panagos, MD
• Jane A Paradowski
• Parimal Parekh
• Parkview Home of Freeport, Illinois, Inc.
• Bhadresh A Patel, MD
• Pathway Physical Therapy LLC
• Patricia M Egan and Associates LLC
• Patricia M Egan Psy.D.

• Durable Medical Equipment & Medical Supplies in Freeport, IL
• Providers in Freeport, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 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.