NPIMap

Organization Active NPI

Dekalb Eye Consultants, LLC

  • Optometrist
  • Loves Park, IL
National Provider Identifier
1851899686
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DEKALB EYE CONSULTANTS, LLC
Practice address
4105 N Perryville Rd
Loves Park, IL 61111-8653
Phone
(815) 395-8338
NPI assigned
Jan 26, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 5, 2020

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

Authorized official

Name
George L Neal
Title
Chief Executive Officer
Phone
(469) 214-0144

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

4105 N Perryville Rd
Loves Park, IL 61111-8653

Mailing address

1630 Gateway Dr
Sycamore, IL 60178-3182
Phone (815) 756-8571

Other names 1

  • Yavitz Eye Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Dekalb Eye Consultants LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4105 N Perryville Rd
Loves Park, IL 61111
Phone (815) 222-1302

NPI Registry JSON

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

{
    "created_epoch": "1516924800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1851899686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1630 GATEWAY DR",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783182",
            "telephone_number": "815-756-8571",
            "fax_number": "815-756-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 N PERRYVILLE RD",
            "city": "LOVES PARK",
            "state": "IL",
            "postal_code": "611118653",
            "telephone_number": "815-395-8338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB EYE CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-26",
        "last_updated": "2020-02-05",
        "certification_date": "2020-02-05",
        "status": "A",
        "authorized_official_last_name": "NEAL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "469-214-0144"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yavitz Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Loves Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 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.

Verify at the official NPI Registry.