Lincoln Park Eyes LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

03695646 Issued in IL

Legal business name

LINCOLN PARK EYES LLC

Practice address

2842 N Sheridan Rd
Chicago, IL 60657

Phone

(773) 525-8700

Fax

(773) 525-8699

NPI assigned

Mar 7, 2012

Last updated

Mar 7, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Frederic A Banser, ODNPI 1811063431

Title

President

Phone

(773) 525-8700

Specialties & licenses 1

Addresses

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.

• Frederic A Banser, OD

  • Optometrist
  • Chicago, IL
  • NPI 1811063431
  Authorized official Same address or phone
• Gina M Rogers, M.D.

  • Ophthalmology Physician
  • Chicago, IL
  • NPI 1609042902
  NPD

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

{
    "created_epoch": "1331078400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331078400000",
    "number": "1902170012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2842 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-525-8700",
            "fax_number": "773-525-8699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2842 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60657",
            "telephone_number": "773-525-8700",
            "fax_number": "773-525-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN PARK EYES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-07",
        "last_updated": "2012-03-07",
        "status": "A",
        "authorized_official_last_name": "BANSER",
        "authorized_official_first_name": "FREDERIC",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-525-8700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "03695646",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lincoln Park Dialysis Services Inc
• Lincoln Park Family Physicians SC
• Lincoln Park Heart Center, S.C.
• Lincoln Park Home Health Care, Inc.
• Lincoln Park OBGYN SC
• Lincoln Park Open MRI, LLC (Lake Shore Open MRI & CT)

• 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 Mar 7, 2012; 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.