MR. DYLEN ADAIR LARSEN (NPI# 1023379773) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023379773 |
| Entity Type | Individual |
| Full Name | MR. DYLEN ADAIR LARSEN |
| Credential | ABOC |
| Practice Address |
521 South Street Suite 1 Belvidere IL 61008 |
| Practice Telephone | 8155201303 |
| Practice Fax Number | 8159759327 |
| Mailing Telephone | 8155201303 |
| Mailing Fax Number | 8159759327 |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2012-05-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 156FX1800X |
Technician/Technologist Specialization: Optician |
IL | Eye and Vision Services Providers |
| Street Address |
521 SOUTH STREET SUITE 1 |
| City | BELVIDERE |
| State | IL |
| Zip Code | 61008 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902322944 | Lynsie Merry | Speech-Language Pathologist | 919 E. Sixth St., Belvidere, IL 61008 | 2017-08-22 |
| 1376665224 | Ultrasound of Belvidere LLC | Radiologic Technologist | 1006 Logan Avenue, Belvidere, IL 61008 | 2007-04-04 |
| 1992845093 | Vicki Marie Harrison | Chiropractor | 301 North State Street, Belvidere, IL 61008 | 2007-02-07 |
| 1316007859 | Drs Drake Ltd | Dentist | 515 Pearl Street, Belvidere, IL 61008 | 2006-12-12 |
| 1194898015 | Family Optical Centre Inc | Optometrist | 304 No State St, Belvidere, IL 61008 | 2006-11-16 |
| 1457373946 | Mary Simmons | Family Medicine | 1700 Henry Luckow Ln, Belvidere, IL 61008 | 2006-07-24 |
| 1134172166 | Gabriel John Javurek | Chiropractor | 1800 Logan Ave, Belvidere, IL 61008 | 2006-05-19 |
| 1437642535 | Bailey A Bolwerk | Physical Therapist | 1731 Henry Luckow Ln, Belvidere, IL 61008 | 2018-06-13 |
| 1184079451 | Amanda L Ritter | Nurse Practitioner | 1700 Henry Luckow Ln, Belvidere, IL 61008 | 2016-04-25 |
| 1104259894 | Erica J Hoyer | Registered Nurse | 1700 Henry Luckow Ln, Belvidere, IL 61008 | 2013-08-16 |
| Find all providers in zip 61008 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346546140 | Optical Outlet of Belvider | Technician/Technologist | 2026 N State St # H, Belvidere, IL 61008-1957 | 2011-01-27 |
| 1174608475 | Wal-mart Stores, Inc | Technician/Technologist | 2101 Gateway Center Dr, Belvidere, IL 61008-9310 | 2006-10-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902445570 | Kami Optical Corp | Technician/Technologist | 1163 E Ogden Ave Ste 701, Naperville, IL 60563-8535 | 2019-12-31 |
| 1750847281 | National Vision Inc | Technician/Technologist | 750 S Rand Rd, Lake Zurich, IL 60047-2467 | 2019-02-20 |
| 1700364171 | National Vision Inc | Technician/Technologist | 4068 North Milwaukee Avenue, Chicago, IL 60641 | 2018-07-30 |
| 1720571615 | National Vision, Inc. | Technician/Technologist | 6931 Grand Ave Ste E2, Gurnee, IL 60031-1610 | 2018-06-14 |
| 1023528619 | Direct Healthcare Solutions LLC | Technician/Technologist | 1520 Fringetree Ln, Woodridge, IL 60517-4653 | 2017-10-09 |
| 1184140014 | Efp Opticians On Dearborn, LLC | Technician/Technologist | 1205 N Dearborn St, Chicago, IL 60610-2213 | 2017-08-22 |
| 1235668245 | Vision Man | Technician/Technologist | 8335 Grand Ave, River Grove, IL 60171-1434 | 2017-06-05 |
| 1033662200 | National Vision, Inc. | Technician/Technologist | 348 W Army Trail Rd, Suite 130, Bloomingdale, IL 60108-5608 | 2016-07-25 |
| 1780039115 | Wal-mart Stores, Inc. | Technician/Technologist | 365 Lake Marian Road, Carpentersville, IL 60110 | 2016-05-04 |
| 1346695392 | National Vision, Inc. | Technician/Technologist | 714 S Randall Rd, Algonquin, IL 60102-5915 | 2016-04-27 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.