NPIMap

Organization Active NPI

Marvin H Heimlich,OD LLC

Doing business as Libertyville Vision Center

  • Optometrist
  • Libertyville, IL
National Provider Identifier
1689753675
Registry record updated Mar 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MARVIN H HEIMLICH,OD LLC
Doing business as
Libertyville Vision Center
Practice address
307 S Milwaukee Ave
Libertyville Vision Center
Libertyville, IL 60048
Phone
(847) 362-3444
Fax
(847) 362-4672
NPI assigned
Nov 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2009

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

Authorized official

Name
Dr. Marvin Harold Heimlich, O.D.NPI 1316026313
Title
Owner
Phone
(847) 362-6444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

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

Addresses

Primary practice location

307 S Milwaukee Ave
Libertyville Vision Center
Libertyville, IL 60048

Mailing address

307 S Milwaukee Ave
Libertyville Vision Center
Libertyville, IL 60048
Phone (847) 362-3444

Other identifiers 3

IdentifierTypeStateIssuer
4915133OtherILBLUE CROSS/BLUE SHIELD
IL7448-001OtherILEYEMED VISION CARE
2116789OtherILAETNA

Other names 1

  • LIBERTYVILLE VISION CENTER Doing business as

National Provider Directory

National Provider Directory

Locations

307 S Milwaukee Ave
Libertyville, IL 60048
Phone (847) 362-3444

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238457600000",
    "number": "1689753675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 S MILWAUKEE AVE",
            "address_2": "LIBERTYVILLE VISION CENTER",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "60048",
            "telephone_number": "847-362-3444",
            "fax_number": "847-362-4672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 S MILWAUKEE AVE",
            "address_2": "LIBERTYVILLE VISION CENTER",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "60048",
            "telephone_number": "847-362-3444",
            "fax_number": "847-362-4672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARVIN H HEIMLICH,OD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2009-03-31",
        "status": "A",
        "authorized_official_last_name": "HEIMLICH",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "HAROLD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-362-6444",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "4915133",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED VISION CARE",
            "identifier": "IL7448-001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "2116789",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIBERTYVILLE VISION CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Libertyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2009; 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.