Midwest Optometric Services P C

Primary specialty

Eyewear SupplierTaxonomy code 332H00000X

License

046007225 Issued in IL

Legal business name

MIDWEST OPTOMETRIC SERVICES P C

Practice address

7451 Woodward Ave
Suite 101
Woodridge, IL 60517-2665

Phone

(630) 663-9112

Fax

(630) 663-9228

NPI assigned

Mar 26, 2008

Last updated

Jun 1, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Leo J Prentice, O.D.NPI 1144212028

Title

Owners

Phone

(630) 663-9112

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Leo J Prentice, O.D.

  • Optometrist
  • Woodridge, IL
  • NPI 1144212028
  Authorized official Same address or phone

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

{
    "created_epoch": "1206489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275350400000",
    "number": "1700058187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7451 WOODWARD AVE",
            "address_2": "SUITE 101",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605172665",
            "telephone_number": "630-663-9112",
            "fax_number": "630-663-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7451 WOODWARD AVE",
            "address_2": "SUITE 101",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605172665",
            "telephone_number": "630-663-9112",
            "fax_number": "630-663-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST OPTOMETRIC SERVICES P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-26",
        "last_updated": "2010-06-01",
        "status": "A",
        "authorized_official_last_name": "PRENTICE",
        "authorized_official_first_name": "LEO",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNERS",
        "authorized_official_telephone_number": "630-663-9112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "IL",
            "license": "046007225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Eyewear Supplier in Woodridge, IL
• Providers in Woodridge, IL by specialty
• Eyewear Supplier in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2010; 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.