Active NPI
Micaela Toledo, O.D.
- Optometrist
- Evergreen Park, IL
National Provider Identifier
1831415702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046.010295
- Practice address
- 9400 S Western Ave
Evergreen Park, IL 60805-2509 - Phone
- (708) 636-5301
- Fax
- (708) 636-6518
- NPI assigned
- Apr 15, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046.010295 | IL | Primary |
Addresses
Primary practice location
9400 S Western Ave
Evergreen Park, IL 60805-2509
Mailing address
8347 S 79TH CT
Justice, IL 60458-2321
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046.010295 | IL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271289600000",
"number": "1831415702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8347 S 79TH CT",
"city": "JUSTICE",
"state": "IL",
"postal_code": "604582321"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9400 S WESTERN AVE",
"city": "EVERGREEN PARK",
"state": "IL",
"postal_code": "608052509",
"telephone_number": "708-636-5301",
"fax_number": "708-636-6518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TOLEDO",
"first_name": "MICAELA",
"name_prefix": "Miss",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-04-15",
"last_updated": "2010-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046.010295",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Evergreen Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.