DR. KENNETH RONALD MINARIK (NPI# 1598834293) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598834293 |
| Entity Type | Individual |
| Full Name | DR. KENNETH RONALD MINARIK |
| Credential | OD |
| Practice Address |
121 N Madison St Rockford IL 61107-3949 |
| Practice Telephone | 8159633454 |
| Practice Fax Number | 8159634384 |
| Mailing Telephone | 8159633454 |
| Mailing Fax Number | 8159634384 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | IL | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 08123272 | 01 |
| Street Address |
121 N MADISON ST |
| City | ROCKFORD |
| State | IL |
| Zip Code | 61107-3949 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639252273 | Northern Illinois Optical Co Inc | Technician/Technologist | 121 N Madison St, Rockford, IL 61107-3949 | 2006-10-24 |
| 1407925100 | Carl Michael Simone | Optometrist | 121 N Madison St, Rockford, IL 61107-3949 | 2006-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356952139 | Jessica Marie Tamayo Fernandez | Pharmacist | 1145 Alpine Rd, Rockford, IL 61107 | 2020-08-13 |
| 1467092379 | Unknown Safa Fatima | Student in an Organized Health Care Education/Training Program | Mercyhealth Mulford Clinic, 5970 Churchview Drive, Rockford, IL 61107 | 2020-01-08 |
| 1194367912 | Matt J Kriebs | Nurse Practitioner | 1235 N Mulford Rd Suite 103, Rockford, IL 61107 | 2019-10-14 |
| 1265962336 | Mary Golembeck | Nurse Practitioner | 7290 Argus Dr, Rockford, IL 61107 | 2017-06-12 |
| 1831644749 | Tessa Lee | Occupational Therapist | 3422 Lauderdale Ln, Rockford, IL 61107 | 2016-08-20 |
| 1942626965 | Elevated Health Essentials, LLC | Chiropractor | 124 N Water St Ste 204e, Rockford, IL 61107 | 2014-03-14 |
| 1093139909 | Swedishamerican Hospital | Surgery | 1639 N Alpine Rd Ste 400, Rockford, IL 61107 | 2014-02-12 |
| 1346676582 | Christopher Anthony Ziganto | Pharmacist | 494 Bienterra Trail #2, Rockford, IL 61107 | 2013-09-19 |
| 1023358272 | Lavanya Durairajan | Physical Therapist | 7358 Shiligton Dr, Rockford, IL 61107 | 2013-02-26 |
| 1851523146 | Great Smiles of Rockford | Durable Medical Equipment & Medical Supplies | 780 N. Mulfrord Road, Rockford, IL 61107 | 2009-08-20 |
| Find all providers in zip 61107 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| 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] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831749548 | Manpreet Kaur Dhaliwal | Optometrist | 6055 E State St Ste D01a, Rockford, IL 61108-2512 | 2019-09-14 |
| 1396399804 | Freedom Vision Centers LLC | Optometrist | 6150 E State St Ste 130, Rockford, IL 61108-2524 | 2019-08-01 |
| 1679127021 | Rosalba Ramirez | Optometrist | 5915 E Riverside Blvd, Rockford, IL 61114-4935 | 2019-07-24 |
| 1295214435 | Neil Patel | Optometrist | 7200 Harrison Ave Unit F35, Rockford, IL 61112-3014 | 2018-08-08 |
| 1568839231 | Irina Rutkowski | Optometrist | 1603 N Alpine Rd Ste 121, Rockford, IL 61107-1439 | 2015-08-28 |
| 1053603837 | Hina N Patel | Optometrist | 4777 E State St # 6, Rockford, IL 61108-8802 | 2011-05-11 |
| 1114237435 | Erica L Touhill-watson | Optometrist | 6790 Cannon Farms Dr Ne, Rockford, MI 49341-7720 | 2010-10-20 |
| 1952615684 | Aman Jalota | Optometrist | 6430 E State St, Rockford, IL 61108-2529 | 2010-08-05 |
| 1821248287 | Michael S. Feldt, O.d., Ltd. | Optometrist | 1640 Broadway, Rockford, IL 61104-6000 | 2008-09-23 |
| 1316107568 | Wight Optometric PC | Optometrist | 1975 Pawlisch Dr, Rockford, IL 61112-1069 | 2008-06-11 |
| Find all providers in ROCKFORD | ||||
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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.