NPIMap

Organization Active NPI

Industrial Optical Service, Inc.

  • Optometrist
  • Evanston, IL
National Provider Identifier
1679623714
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
INDUSTRIAL OPTICAL SERVICE, INC.
Practice address
2000 Central St
Evanston, IL 60201-2218
Phone
(847) 864-0300
NPI assigned
Jan 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Authorized official

Name
Daniel Lieberman, O.D.
Title
Owner
Phone
(847) 864-0300

Specialties & licenses 1

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

Addresses

Primary practice location

2000 Central St
Evanston, IL 60201-2218

Mailing address

4418 W Diversey Ave
Chicago, IL 60639-1924
Phone (773) 736-6800

Other identifiers 2

IdentifierTypeStateIssuer
1636706OtherILBCBS
7235044OtherILAETNA

Other names 1

  • Coventry Eyecare Doing business as

National Provider Directory

National Provider Directory

Locations

4418 W Diversey Ave
Chicago, IL 60639
Phone (312) 945-7192

Practitioners & affiliated clinicians

Practitioners 10

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": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1679623714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4418 W DIVERSEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391924",
            "telephone_number": "773-736-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 CENTRAL ST",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602012218",
            "telephone_number": "847-864-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDUSTRIAL OPTICAL SERVICE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "LIEBERMAN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-864-0300",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1636706",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7235044",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coventry Eyecare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Evanston, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.