NPIMap

Organization Active NPI

Choice Eye Care, LTD

  • Optometrist
  • Lisle, IL
National Provider Identifier
1962532820
Registry record updated Apr 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046006373 Issued in IL
Legal business name
CHOICE EYE CARE, LTD
Practice address
4760 Main St
Lisle, IL 60532-1724
Phone
(630) 969-2020
Fax
(630) 969-1415
NPI assigned
Mar 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2012

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

Authorized official

Name
Dr. Thomas F Stazak, O.D.
Title
Owner
Phone
(630) 969-2020

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 046006373 IL Primary

Addresses

Primary practice location

4760 Main St
Lisle, IL 60532-1724

Mailing address

4760 Main St
Lisle, IL 60532-1724
Phone (630) 969-2020

Other identifiers 1

IdentifierTypeStateIssuer
410022192OtherILRAILROAD

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335139200000",
    "number": "1962532820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4760 MAIN ST",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321724",
            "telephone_number": "630-969-2020",
            "fax_number": "630-969-1415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4760 MAIN ST",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605321724",
            "telephone_number": "630-969-2020",
            "fax_number": "630-969-1415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOICE EYE CARE, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2012-04-23",
        "status": "A",
        "authorized_official_last_name": "STAZAK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-969-2020",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046006373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "410022192",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lisle, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.