Individual provider Active NPI

Alan E Knotek, O.D.

  • Optometrist
  • Naperville, IL
National Provider Identifier
1700842341
Registry record updated May 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-006864 Issued in IL
Practice address
29 S Webster St
Suite 104
Naperville, IL 60540-5356
Phone
(630) 357-6880
Fax
(630) 357-6995
NPI assigned
Apr 22, 2006
Last updated
May 17, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 17, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-006864 IL Primary

Addresses

Primary practice location

29 S Webster St
Suite 104
Naperville, IL 60540-5356

Mailing address

29 S Webster St
Suite 104
Naperville, IL 60540-5356
Phone (630) 357-6880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-006864ILMDOptometrist

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1145664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274054400000",
    "number": "1700842341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29 S WEBSTER ST",
            "address_2": "SUITE 104",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605405356",
            "telephone_number": "630-357-6880",
            "fax_number": "630-357-6995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 S WEBSTER ST",
            "address_2": "SUITE 104",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605405356",
            "telephone_number": "630-357-6880",
            "fax_number": "630-357-6995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOTEK",
        "first_name": "ALAN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-22",
        "last_updated": "2010-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-006864",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 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.