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KIMBERLY MATHIS-HARRIS NPI 1730754169


NPI Information

NPI: 1730754169
Provider Name: KIMBERLY MATHIS-HARRIS
Classification: Eyewear Supplier - 332H00000X
Entity Type: Organization
Address:
1439 W 103RD ST STE 3
CHICAGO, IL
ZIP 60643
Phone: (773) 339-6556
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KIMBERLY MATHIS-HARRIS is an eyewear supplier in Chicago, IL. The provider is an organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. KIMBERLY MATHIS-HARRIS NPI is 1730754169. The provider is registered as an organization entity type.

The provider's business location address is:

1439 W 103RD ST STE 3
CHICAGO, IL
ZIP 60643-900
Phone: (773) 339-6556
Fax: (773) 701-6055

The provider's authorized official is Kimberly Maria Mathis-harris .
The authorized official title is Owner and has the following contact phone number (773) 339-6556.

The enumeration date for this NPI number is 5/27/2021 and was last updated on 5/27/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1332H00000XEyewear SupplierYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11619566627MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.