Organization Active NPI

Viking Eyecare LLC

Doing business as Pearle Vision

  • Optometrist
  • Geneva, IL
National Provider Identifier
1861668345
Registry record updated Apr 2, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009196 Issued in IL
Legal business name
VIKING EYECARE LLC
Doing business as
Pearle Vision
Practice address
1749 S Randall Rd Ste F
Geneva, IL 60134-4616
Phone
(630) 845-9110
Fax
(630) 845-9118
NPI assigned
May 5, 2008
Last updated
Apr 2, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2009

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

Authorized official

Name
Dr. Michael T Tweed, ODNPI 1154456671
Title
Optometrist
Phone
(630) 845-9110

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009196 IL Primary

Addresses

Primary practice location

1749 S Randall Rd Ste F
Geneva, IL 60134-4616

Mailing address

1749 S Randall Rd Ste F
Geneva, IL 60134-4616
Phone (630) 845-9110

Other names 1

  • Pearle Vision Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081205000712 IL Part B Supplier - Clinic/Group Practice 8527129725 Receives reassigned benefits from 2 practitioners
Practice locations: Geneva, IL

National Provider Directory

National Provider Directory

Locations

1749 S Randall Rd
Geneva, IL 60134

1749 S Randall Rd
Ste F
Geneva, IL 60134
Phone (630) 845-9110

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1209945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1238630400000",
    "number": "1861668345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1749 S RANDALL RD STE F",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344616",
            "telephone_number": "630-845-9110",
            "fax_number": "630-845-9118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1749 S RANDALL RD STE F",
            "city": "GENEVA",
            "state": "IL",
            "postal_code": "601344616",
            "telephone_number": "630-845-9110",
            "fax_number": "630-845-9118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIKING EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-05",
        "last_updated": "2009-04-02",
        "status": "A",
        "authorized_official_last_name": "TWEED",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "630-845-9110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Geneva, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2009; 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.