La Vallee Optometric LTD.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046009075 Issued in IL

Legal business name

LA VALLEE OPTOMETRIC LTD.

Practice address

2111 W Superior St
Chicago, IL 60612-1315

Phone

(773) 895-3411

Fax

(312) 226-0802

NPI assigned

Dec 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Keith La Vallee, O.D.NPI 1023080553

Title

President

Phone

(773) 895-3411

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL, IN2 enrollments

Enrollment records 2

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keith La Vallee, O.D.

  • Optometrist
  • Chicago, IL
  • NPI 1023080553

  IN

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222646400000",
    "number": "1851459481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2111 W SUPERIOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121315",
            "telephone_number": "773-895-3411",
            "fax_number": "312-226-0802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2111 W SUPERIOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606121315",
            "telephone_number": "773-895-3411",
            "fax_number": "312-226-0802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LA VALLEE OPTOMETRIC LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2008-09-29",
        "status": "A",
        "authorized_official_last_name": "LA VALLEE",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-895-3411",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• La Rabida Children'S Hospital
• La Rabida Children'S Hospital
• La Rabida Childrens Hospital Pharmacy
• Cristina La Rosa, O.D.
• Andrew La Valle
• Keith La Vallee, O.D.
• Megan La Vigne, OT
• Anh Soh La, DDS
• Ashley La, MD
• Lan La, M.S.

• Optometrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.