PHC of Buffalo Grove Optometry

Primary specialty

OptometristTaxonomy code 152W00000X

License

046010327 Issued in IL

Legal business name

PHC OF BUFFALO GROVE OPTOMETRY

Doing business as

Portrait Health Centers of Buffalo Grove Optometry

Practice address

150 W Half Day Rd
Suite 105
Buffalo Grove, IL 60089-6591

Phone

(847) 868-3435

Fax

(847) 859-5855

NPI assigned

Feb 16, 2011

Last updated

Aug 9, 2011By 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. Lexi Surber, OD

Title

President

Phone

(847) 868-3435

Specialties & licenses 1

Addresses

Other names 1

• Portrait Health Centers of Buffalo Grove Optometry Doing business as

Locations

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

{
    "created_epoch": "1297814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312848000000",
    "number": "1710284419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 W HALF DAY RD",
            "address_2": "SUITE 105",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896591",
            "telephone_number": "847-868-3435",
            "fax_number": "847-859-5855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 W HALF DAY RD",
            "address_2": "SUITE 105",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600896591",
            "telephone_number": "847-868-3435",
            "fax_number": "847-859-5855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHC OF BUFFALO GROVE OPTOMETRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-16",
        "last_updated": "2011-08-09",
        "status": "A",
        "authorized_official_last_name": "SURBER",
        "authorized_official_first_name": "LEXI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-868-3435",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portrait Health Centers of Buffalo Grove Optometry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sarah Cathleen Peterson, M.D.
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• PHC of Buffalo Grove Diagnostic Services (Portrait Health Centers Diagnostic Services)
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• Anna Marie Phillips, PA-C
• Physiotherapy Associates (The Pediatric Place)
• Megan Placko
• Planned Eldercare Inc

• Optometrist in Buffalo Grove, IL
• Providers in Buffalo Grove, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2011; 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.