NPIMap

Organization Active NPI

Dekalb Eye Consultants, LLC

Doing business as Rockford Retina Clinic

  • Ophthalmology Physician
  • Rockford, IL
National Provider Identifier
1922507474
Registry record updated Feb 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
DEKALB EYE CONSULTANTS, LLC
Doing business as
Rockford Retina Clinic
Practice address
1075 Featherstone Rd Ste 10
Rockford, IL 61107-5906
Phone
(815) 395-1157
NPI assigned
Feb 9, 2018
Last updated
Feb 5, 2020By the provider in NPPES
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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

1075 Featherstone Rd Ste 10
Rockford, IL 61107-5906

Mailing address

1630 Gateway Dr
Sycamore, IL 60178-3182
Phone (815) 856-8571

Other names 1

  • Rockford Retina Clinic 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.

NPI Registry JSON

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

{
    "created_epoch": "1518134400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580860800000",
    "number": "1922507474",
    "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": "815-856-8571",
            "fax_number": "815-756-5603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 FEATHERSTONE RD STE 10",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611075906",
            "telephone_number": "815-395-1157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALB EYE CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-02-09",
        "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": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rockford Retina Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Rockford, 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.