Organization Active NPI

Plano Child Development Center

  • Vision Therapy Optometrist
  • Chicago, IL
National Provider Identifier
1962639781
Registry record updated Jun 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vision Therapy OptometristTaxonomy code 152WV0400X
Legal business name
PLANO CHILD DEVELOPMENT CENTER
Practice address
5401 S Wentworth Ave Ste 14a
Chicago, IL 60609-6300
Phone
(773) 924-5297
Fax
(773) 373-3548
NPI assigned
Jun 18, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2009

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

Authorized official

Name
Dr. Robert L. Johnson Sr., O.D.
Title
President
Phone
(773) 924-5297

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vision Therapy OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152WV0400X Primary

Addresses

Primary practice location

5401 S Wentworth Ave Ste 14a
Chicago, IL 60609-6300

Mailing address

5401 S Wentworth Ave Ste 14a
Chicago, IL 60609-6300
Phone (773) 924-5297

National Provider Directory

National Provider Directory

Locations

5401 S Wentworth Ave
Ste 14A
Chicago, IL 60609
Phone (773) 924-5297

NPI Registry JSON

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

{
    "created_epoch": "1245283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245283200000",
    "number": "1962639781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 S WENTWORTH AVE STE 14A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606096300",
            "telephone_number": "773-924-5297",
            "fax_number": "773-373-3548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5401 S WENTWORTH AVE STE 14A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606096300",
            "telephone_number": "773-924-5297",
            "fax_number": "773-373-3548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLANO CHILD DEVELOPMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-18",
        "last_updated": "2009-06-18",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-924-5297",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WV0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; 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.