Organization Active NPI

DRS. Distin & Doyle, Optometrists

  • Optometrist
  • Aledo, IL
National Provider Identifier
1710190756
Registry record updated Oct 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DRS. DISTIN & DOYLE, OPTOMETRISTS
Practice address
2108 S. E 3D St
Aledo, IL 61231-9456
Phone
(309) 582-5673
Fax
(309) 582-5674
NPI assigned
May 7, 2007
Last updated
Oct 22, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2010

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

Authorized official

Name
Mary G Distin
Title
Office Manager
Phone
(309) 582-5673

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

2108 S. E 3D St
Aledo, IL 61231-9456

Mailing address

2108 S. E. Third St
Aledo, IL 61231-9456
Phone (309) 582-5673

National Provider Directory

National Provider Directory

Locations

67 Public Sq
Monmouth, IL 61462
Phone (309) 734-3108

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287705600000",
    "number": "1710190756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2108 S. E. THIRD ST",
            "city": "ALEDO",
            "state": "IL",
            "postal_code": "612319456",
            "telephone_number": "309-582-5673",
            "fax_number": "309-582-5674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2108 S. E 3D ST",
            "city": "ALEDO",
            "state": "IL",
            "postal_code": "612319456",
            "telephone_number": "309-582-5673",
            "fax_number": "309-582-5674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. DISTIN & DOYLE, OPTOMETRISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-07",
        "last_updated": "2010-10-22",
        "status": "A",
        "authorized_official_last_name": "DISTIN",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "309-582-5673"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aledo, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 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.