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DERRALD G TAYLOR OD NPI 1497748982


NPI Information

NPI: 1497748982
Provider Name: DERRALD G TAYLOR, OD
Classification: Optometrist - 152W00000X
Entity Type: Individual
Organization: INTERSTATE OPTICAL LBR INC

PECOS Registration: Yes

Address:
3241 S MICHIGAN AVE
CHICAGO, IL
ZIP 60616
Phone: (312) 225-6200
Get Directions

Derrald G Taylor, OD is an optometrist in Chicago, IL with 56 years of experience. The provider is 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. Derrald G Taylor, OD NPI is 1497748982. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Graduation Year:1968

The provider's business location address is:

3241 S MICHIGAN AVE
CHICAGO, IL
ZIP 60616-849
Phone: (312) 225-6200
Fax: (312) 949-7660

The NPI 1497748982 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 8/30/2005 and was last updated on 12/22/2008.


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
1152W00000XOptometrist046006305ILLINOISYes

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
1T36499MEDICARE UPIN
2P15679MEDICARE PINILLINOIS
3046006305MEDICAIDILLINOIS

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: 11/14/2023

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.