Jeffrey Dannatt LTD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046008969 Issued in IL

Legal business name

JEFFREY DANNATT LTD

Practice address

5020 N 2ND St
Loves Park, IL 61111-5809

Phone

(815) 282-3468

NPI assigned

Mar 25, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Dannatt, OD

Title

Optometrist

Phone

(815) 282-3468

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1458864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1458864000000",
    "number": "1821450081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5020 N 2ND ST",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611115809",
            "telephone_number": "815-282-3468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5020 N 2ND ST",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611115809",
            "telephone_number": "815-282-3468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEFFREY DANNATT LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-25",
        "last_updated": "2016-03-25",
        "status": "A",
        "authorized_official_last_name": "DANNATT",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "815-282-3468",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008969",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samuel Janczak, LMT
• Leah Jankowski, M.ED, ATC
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• John M. Jaworowicz, M.D.
• Reginald Jean Gilles
• Jennifer Dungan OD PLLC
• John V Kim DDS PC
• Matthew Russell Johnsom, EMT
• Terry Joiner, DDS
• Jessica Jordan

• Optometrist in Loves Park, IL
• Providers in Loves Park, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2016; 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.