Milan Optical Inc. – Eyewear Supplier in Milan, IL

Key facts

NPI: 1962736876
Entity type: Organization (NPI type 2)
Primary specialty: Eyewear Supplier 332H00000X
License: 3961-2384 IBT (IL)
Legal business name: MILAN OPTICAL INC.
Practice address: 1929 East 10TH Avenue
Milan, IL 61264
Phone: (309) 787-8100
NPI assigned: Sep 24, 2009
Organization subpart: No

Authorized official

Name: Mrs. Renea Hainline
Title: President
Phone: (309) 787-8100

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Lacey Elizabeth Hainline I, OD Optometrist · Milan, IL · NPI 1073171914

Medicare reassignment NPD IL

Medicare participation

Medicare fee-for-service enrollment: Enrolled in IL

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20190905003100	IL	Part B Supplier - Clinic/Group Practice	3779812417	Receives reassigned benefits from 1 practitioner Practice locations: Milan, IL

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Eyewear Supplier	332H00000X	3961-2384 IBT	IL	Yes

Addresses

Primary practice location

1929 East 10TH Avenue
Milan, IL 61264

Mailing address

1929 East 10TH Avenue
Milan, IL 61264
Phone (309) 787-8100

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 24, 2009.

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1253750400000",
    "number": "1962736876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1929 EAST 10TH AVENUE",
            "city": "MILAN",
            "state": "IL",
            "postal_code": "61264",
            "telephone_number": "309-787-8100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1929 EAST 10TH AVENUE",
            "city": "MILAN",
            "state": "IL",
            "postal_code": "61264",
            "telephone_number": "309-787-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILAN OPTICAL INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-24",
        "last_updated": "2009-09-24",
        "status": "A",
        "authorized_official_last_name": "HAINLINE",
        "authorized_official_first_name": "RENEA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-787-8100",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "IL",
            "license": "3961-2384 IBT",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milan, IL

All providers in Milan, IL · Eyewear Supplier in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2009. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.