Ophthalmic Support Sytems of Chicago

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

PENDING Issued in IL

Legal business name

OPHTHALMIC SUPPORT SYTEMS OF CHICAGO

Practice address

1942 W Wolfram St
Chicago, IL 60657-4032

Phone

(773) 404-2148

Fax

(773) 404-9270

NPI assigned

Nov 5, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Sybil Anita Montgomery

Title

President

Phone

(773) 404-2148

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1162684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720167141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1942 W WOLFRAM ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574032",
            "telephone_number": "773-404-2148",
            "fax_number": "773-404-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1942 W WOLFRAM ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606574032",
            "telephone_number": "773-404-2148",
            "fax_number": "773-404-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPHTHALMIC SUPPORT SYTEMS OF CHICAGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MONTGOMERY",
        "authorized_official_first_name": "SYBIL",
        "authorized_official_middle_name": "ANITA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-404-2148",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IL",
            "license": "PENDING",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Chicago, IL
• Providers in Chicago, IL by specialty
• Durable Medical Equipment & Medical Supplies in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.