Optical Pro, Inc

Primary specialty

OpticianTaxonomy code 156FX1800X

License

13-ACM-0096 Issued in IL

Legal business name

OPTICAL PRO, INC

Practice address

1525 Ogden Ave
Suite C
Downers Grove, IL 60515-2776

Phone

(630) 963-3260

NPI assigned

Apr 29, 2015

Organization subpart

No

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

Authorized official

Name

Magdy Mina

Title

Owner

Phone

(630) 963-3260

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430265600000",
    "number": "1871970715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 OGDEN AVE",
            "address_2": "SUITE C",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152776",
            "telephone_number": "630-963-3260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 OGDEN AVE",
            "address_2": "SUITE C",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605152776",
            "telephone_number": "630-963-3260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTICAL PRO, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-04-29",
        "status": "A",
        "authorized_official_last_name": "MINA",
        "authorized_official_first_name": "MAGDY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-963-3260"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Technician/Technologist, Optician",
            "state": "IL",
            "license": "13-ACM-0096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2015; 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.