Shopko Optical 4243 is a
Eyewear Supplier based in Dekalb, Illinois. Shopko Optical 4243 is licensed to practice in NU (license number ) and their current practice location is
2101 Sycamore Rd, Dekalb, Illinois. It can be reached at their office (for appointments etc.) via phone at
(815) 766-3516.
NPI number for Shopko Optical 4243 is 1396324570 and their current mailing address is Po Box 19060, Green Bay, Wisconsin. Shopko Optical 4243
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1396324570.
Healthcare Provider's Profile
| Full Name | Shopko Optical 4243 |
|---|
| Type | Facility |
|---|
| Speciality | Eyewear Supplier |
|---|
| Location | 2101 Sycamore Rd, Dekalb, Illinois |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
NPI Data:
- NPI Number: 1396324570
- Provider Enumeration Date: 04/06/2021
- Last Update Date: 11/29/2024
Medical Identifiers
Medical identifiers for Shopko Optical 4243 such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1396324570 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 152W00000X | Optometrist | (NU) | Secondary |
| 332H00000X | Eyewear Supplier | (NU) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shopko Optical 4243 is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Shopko Optical 4243 Po Box 19060, Green Bay, WI 54307-9060 Ph: (920) 429-2211 | Shopko Optical 4243 2101 Sycamore Rd, Dekalb, IL 60115-2045 Ph: (815) 766-3516 |
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