NPIMap

Organization Active NPI

Ma Optical, PLLC

  • Optometrist
  • Niles, IL
National Provider Identifier
1992441216
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MA OPTICAL, PLLC
Practice address
7421 N Milwaukee Ave
Niles, IL 60714-3707
Phone
(773) 631-2980
Fax
(773) 389-7211
NPI assigned
May 10, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Authorized official

Name
Marina ShepelenkoNPI 1033421227
Title
Manager
Phone
(773) 993-0279

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

7421 N Milwaukee Ave
Niles, IL 60714-3707

Mailing address

7421 N Milwaukee Ave
Niles, IL 60714-3707
Phone (773) 993-0279

National Provider Directory

National Provider Directory

Locations

7421 N Milwaukee Ave
Niles, IL 60714
Phone (773) 631-2980

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1652140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682294400000",
    "number": "1992441216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7421 N MILWAUKEE AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143707",
            "telephone_number": "773-993-0279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7421 N MILWAUKEE AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607143707",
            "telephone_number": "773-631-2980",
            "fax_number": "773-389-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MA OPTICAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-10",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A",
        "authorized_official_last_name": "SHEPELENKO",
        "authorized_official_first_name": "MARINA",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "773-993-0279"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.