Professional Eye Care

Primary specialty

OptometristTaxonomy code 152W00000X

License

047.106798 Issued in IL

Legal business name

PROFESSIONAL EYE CARE

Practice address

2017 75TH St
Woodridge, IL 60517-2308

Phone

(630) 427-1000

Fax

(630) 427-1280

NPI assigned

Oct 2, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Srinivas Jairam, ODNPI 1326194101

Title

Owner

Phone

(630) 427-1000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• S JAIRAM OPTOMETRIST LTD Other name

Locations

Practitioners 2

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

• Srinivas Jairam, OD

  • Optometrist
  • Woodridge, IL
  • NPI 1326194101
  NPD (past) Authorized official
• Ann Sonia Kalladanthyil, O.D.

  • Optometrist
  • Woodridge, IL
  • NPI 1013243161
  NPD (past)

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227139200000",
    "number": "1861643355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2017 75TH ST",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605172308",
            "telephone_number": "630-427-1000",
            "fax_number": "630-427-1280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2017 75TH ST",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605172308",
            "telephone_number": "630-427-1000",
            "fax_number": "630-427-1280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL EYE CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-02",
        "last_updated": "2008-11-20",
        "status": "A",
        "authorized_official_last_name": "JAIRAM",
        "authorized_official_first_name": "SRINIVAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-427-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "047.106798",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046006798",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "S JAIRAM OPTOMETRIST LTD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Carla L Pister
• Podiatric Management Systems LLC (Leonard Vekkos, DPM)
• Kevin R Polsley, M.D.
• Leo J Prentice, O.D.
• Mario Prete, MD
• David Protaziuk, FNP
• Fariha Querishi, D.M.D.
• Monina Valencia Quiroga, PT
• Catherine Marie Racanelli, MASSAGE THERAPIST
• Rachel M. George DDS, P.C. (Discover Dental)

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2008; 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.