DRS. Peterson & Jannotta Optometrists PC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

DRS. PETERSON & JANNOTTA OPTOMETRISTS PC

Practice address

4306 W Crystal Lake Rd
Ste D
McHenry, IL 60050-4249

Phone

(815) 385-7930

Fax

(815) 385-9234

NPI assigned

Jun 20, 2007

Last updated

Jan 17, 2008By 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. Daniel Joseph Jannotta, ODNPI 1568568186

Title

Owner Practioner

Phone

(815) 385-7930

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

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.

• Daniel Joseph Jannotta, OD

  • Optometrist
  • McHenry, IL
  • NPI 1568568186
  Authorized official Same address or phone

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

{
    "created_epoch": "1182297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200528000000",
    "number": "1972708790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4306 W CRYSTAL LAKE RD",
            "address_2": "STE D",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600504249",
            "telephone_number": "815-385-7930",
            "fax_number": "815-385-9234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4306 W CRYSTAL LAKE RD",
            "address_2": "STE D",
            "city": "MCHENRY",
            "state": "IL",
            "postal_code": "600504249",
            "telephone_number": "815-385-7930",
            "fax_number": "815-385-9234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS. PETERSON & JANNOTTA OPTOMETRISTS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-20",
        "last_updated": "2008-01-17",
        "status": "A",
        "authorized_official_last_name": "JANNOTTA",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER PRACTIONER",
        "authorized_official_telephone_number": "815-385-7930",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP BC BS",
            "identifier": "05632150",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in McHenry, IL
• Providers in McHenry, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2008; 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.