Active NPI
Manpreet Kaur Dhaliwal, OD
- Optometrist
- Rockford, IL
National Provider Identifier
1831749548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046.011376
- Practice address
- 6055 E State St Ste D01A
Rockford, IL 61108-2512 - Phone
- (815) 394-7412
- NPI assigned
- Sep 14, 2019
- Sex
- Female
- Sole proprietor
- No
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 | 046.011376 | IL | Primary |
Addresses
Primary practice location
6055 E State St Ste D01A
Rockford, IL 61108-2512
Mailing address
6055 E State St Ste D01A
Rockford, IL 61108-2512
Phone (815) 394-7412
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046.011376 | IL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568419200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1582502400000",
"number": "1831749548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6055 E STATE ST STE D01A",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611082512",
"telephone_number": "815-394-7412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6055 E STATE ST STE D01A",
"city": "ROCKFORD",
"state": "IL",
"postal_code": "611082512",
"telephone_number": "815-394-7412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DHALIWAL",
"first_name": "MANPREET",
"middle_name": "KAUR",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-14",
"last_updated": "2020-02-24",
"certification_date": "2020-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046.011376",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rockford, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.