SUSAN M PENNER


Address: 363 S Randall Rd, Elgin, IL 60123
Phone: 8478881555

SUSAN M PENNER (NPI# 1508088683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1508088683
Entity Type Organization
Organization Name SUSAN M PENNER
Other Organization Name ELGIN FAMILY EYE CARE
Practice Address 363 S Randall Rd
Elgin
IL 60123
Practice Telephone 8478881555
Practice Fax Number 8478882508
Mailing Telephone 8478881555
Mailing Fax Number 8478882508
Enumeration Date 2007-05-02
Last Update Date 2008-05-20
Authorized Official Name DR. SUSAN M PENNER (OWNER)
Authorized Official Telephone 8157346500
Authorized Official Credential O.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 152W00000X Optometrist Eye and Vision Services Providers

Other Provider Identifier

State Issuer Identifier Type Code
IL MEDICARE SUPPLIER 0253870001 01
IL BCBS 4515286 01
IL DMERC 0253870002 01

Other Provider/Organization Names

Other Name Type Code
ELGIN FAMILY EYE CARE Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1194917971 Susan M Penner Optometrist 134 E Blackhawk Dr, Byron, IL 61010-8610 2007-08-15

Office Location

Street Address 363 S RANDALL RD
City ELGIN
State IL
Zip Code 60123

Providers in the same location

NPI Name Taxonomy Address Enumeration
1417111790 Michael George Kennedy Optometrist 363 S Randall Rd, Elgin, IL 60123-5526 2008-07-15
1992996383 Ellen Renee Petroczky Optometrist 363 S Randall Rd, Elgin Family Eye Care, Elgin, IL 60123-5526 2007-08-09

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1629625736 Edna Lopez Social Worker 1140 N. Mclean Blvd #1, Elgin, IL 60123 2019-08-22
1003472259 Katelyn Lee O'connell Counselor 695 S. Sate Street, Elgin, IL 60123 2019-05-14
1598235152 Katie Elizabeth Dwyer Counselor 695 S. State Street, Elgin, IL 60123 2018-11-27
1174002778 James M Accetta Counselor 52 Surry Drive, Elgin, IL 60123 2018-08-14
1770086175 Griswold Home Care Adult Companion 707 A Davis Road, Suite 203, Elgin, IL 60123 2018-03-12
1003315706 Danielle Bryant Nurse Practitioner 745 Fletcher Dr Ste 101, Elgin, IL 60123 2018-02-08
1912421470 Deborah Foshager Counselor 680 Shenandoah Trail, Elgin, IL 60123 2017-07-26
1760903470 Miguel Camargo Specialist/Technologist 12 N Aldine St, Elgin, IL 60123 2017-07-03
1134658594 David Sommer Counselor 1460 Umbdenstock Rd, Elgin, IL 60123 2017-06-08
1649719618 Faheem Unisa Syed Clinical Nurse Specialist 1990 Larkin Ave., Elgin, IL 60123 2017-02-23
Find all providers in zip 60123

Taxonomy Information

Taxonomy Code 152W00000X
Grouping Eye and Vision Services Providers
Classification Optometrist

Taxonomy Definition

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1093295305 Clayton William Rutkowski Optometrist 1205 Hwy 290 E, Elgin, TX 78621-2018 2018-08-16
1114470267 Michelle Hanh Ma Optometrist 1205 Highway 290 W, Elgin, TX 78621 2016-07-25
1467826057 Elgin Vision Pllc Optometrist 1205 W. Highway 290, Elgin, TX 78621 2015-11-19
1477986826 Yasham Sharaf Alam Optometrist 502 Waverly Dr, Elgin, IL 60120-4082 2013-08-20
1710137757 Morfoot Eyecare Optometrist 815 S Randall Rd, Elgin, IL 60123-3003 2008-09-26
1598942427 Manal Hajali Optometrist 502 Waverly Drive, Elgin, IL 60120 2008-01-22
1609924745 Toshio Nakajima Optometrist 165 S Randall Rd, Elgin, IL 60123 2007-01-08
1013012327 Family Vision Clinic LLP Optometrist 110 Main St N, Elgin, ND 58533 2006-09-13
1649386608 Maria Jean Nelsen Optometrist 1001 N Randall Rd, Elgin, IL 60123-2319 2006-08-22
1205833225 Jamey C Ware Optometrist 1670 Capital St Ste 100, Elgin, IL 60124-7837 2005-07-05
Find all providers in ELGIN

Competitor

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City ELGIN
Zip Code 60123

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Dataset Information

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.

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