NPIMap

Organization Active NPI

Mobile Vision of Illinois, LLC

  • Optometrist
  • Lemont, IL
National Provider Identifier
1790099125
Registry record updated Jul 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-008265 Issued in IL
Legal business name
MOBILE VISION OF ILLINOIS, LLC
Practice address
1192 Walter St
Lemont, IL 60439-2903
Phone
(630) 269-8518
NPI assigned
Jul 27, 2010
Last updated
Jul 27, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2010

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

Authorized official

Name
Dr. Samuel Joseph Forzley, O.D.NPI 1144230392
Title
Owner/Optometrist
Phone
(630) 269-8518

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 046-008265 IL Primary

Addresses

Primary practice location

1192 Walter St
Lemont, IL 60439-2903

Mailing address

1192 Walter St
Lemont, IL 60439-2903

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1280188800000",
    "number": "1790099125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1192 WALTER ST",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604392903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1192 WALTER ST",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604392903",
            "telephone_number": "630-269-8518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE VISION OF ILLINOIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-07-27",
        "last_updated": "2010-07-27",
        "status": "A",
        "authorized_official_last_name": "FORZLEY",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/OPTOMETRIST",
        "authorized_official_telephone_number": "630-269-8518",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemont, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 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.