SHOPTIKAL LLC (NPI# 1699331082) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699331082 |
| Entity Type | Organization |
| Organization Name | SHOPTIKAL LLC |
| Other Organization Name | SHOPKO OPTICAL 4119 |
| Practice Address |
1600 South Galena Ave Dixon IL 61021 |
| Mailing Address |
Po Box 19060 Green Bay WI 54307-9060 |
| Practice Telephone | 8152843935 |
| Enumeration Date | 2019-05-12 |
| Last Update Date | 2019-12-16 |
| Authorized Official Name | RUSSELL STEINHORST (CEO) |
| Authorized Official Telephone | 9204297489 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Other Name | Type Code |
|---|---|
| Shopko Optical 4119 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427658772 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1073 E Johnson St, Fond Du Lac, WI 54935-8919 | 2020-10-27 |
| 1801493903 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 11995 Business Park Blvd N, Champlin, MN 55316 | 2020-10-02 |
| 1578170247 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 120 N Grand Ave Ste 102, Sun Prairie, WI 53590-9007 | 2020-09-28 |
| 1174138168 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1550 W Lane Rd, Machesney Park, IL 61115-1903 | 2020-09-15 |
| 1639784622 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 2268 W Mason St, Green Bay, WI 54303-4707 | 2020-09-15 |
| 1588279566 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1190 S Randall Rd Ste 104, Elgin, IL 60123-4110 | 2020-09-15 |
| 1427669746 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1607 Losey Blvd S, La Crosse, WI 54601-6151 | 2020-08-11 |
| 1710598032 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 631 Hometown Cir Ste 106, Verona, WI 53593-1561 | 2020-08-11 |
| 1457989006 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 3330 E 10th St, Sioux Falls, SD 57103-2107 | 2020-03-30 |
| 1710512801 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 9940 Rt 47, Huntley, IL 60142 | 2020-03-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | SHOPTIKAL LLC | 700 Pilgrim Way, Green Bay, WI 54304 |
| Iowa Business Entities | SHOPTIKAL LLC | 700 Pilgrim Way, Green Bay, WI 54304 |
| Washington State Corporations | SHOPTIKAL LLC | 700 Pilgrim Way, Green Bay, WI 54304-5263 |
| Street Address |
1600 SOUTH GALENA AVE |
| City | DIXON |
| State | IL |
| Zip Code | 61021 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285135590 | Richard Allen Sibert | Counselor | 325 Il Route 2,dixon Il, Dixon, IL 61021 | 2018-02-22 |
| 1518485432 | Madeline Luniewicz | Counselor | 325 Il-2, Dixon, IL 61021 | 2017-08-30 |
| 1669992566 | Nicole Marie Shaffer | Specialist/Technologist | 650 Reynoldswood Road, Dixon, IL 61021 | 2017-06-21 |
| 1346660446 | Lydia Sitter | Audiologist | 215 3. 1st Street, Suite 317, Ksb Medical Group, Dixon, IL 61021 | 2014-04-16 |
| 1053600080 | Janet I. Malmberg | Nurse Practitioner | 309 South Galena Ave, Suite 100, Dixon, IL 61021 | 2011-03-30 |
| 1376775262 | Kelly L Klein | Optometrist | 511 Palmyra Street, Ksb Eye & Vision Care, Dixon, IL 61021 | 2009-08-11 |
| 1013119106 | Michael Joseph Sarno | Physical Therapist | 401 E. First Street, Dixon, IL 61021 | 2007-06-01 |
| 1891905600 | Thomas G. Gehlbach | Internal Medicine | 215 E 1st St Ste 111, Dixon, IL 61021 | 2007-05-23 |
| 1699987230 | Sameer Jain | Family Medicine | 102 S. Hennepin Ave., Ksb Medical Group, Dixon, IL 61021 | 2007-05-04 |
| 1548484769 | Rebecka D Brinkmann | Physical Therapy Assistant | 215 East 1st St, Suite 318, Dixon, IL 61021 | 2007-04-11 |
| Find all providers in zip 61021 | ||||
| Taxonomy Code | 332H00000X |
| Grouping | Suppliers |
| Classification | Eyewear Supplier (Equipment, not the service) |
| An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780809285 | Illinois Correctional Industries | Eyewear Supplier (Equipment, not the service) | 2600 N Brinton Ave, Dixon, IL 61021-9532 | 2007-04-17 |
| 1700838729 | Shopko Stores Operating Co. LLC | Eyewear Supplier (Equipment, not the service) | 1350 N Galena Ave, Dixon, IL 61021-1010 | 2006-05-17 |
| 1487975603 | Ksb Medical Group, Inc. | Eyewear Supplier (Equipment, not the service) | 511 Palmyra St, Dixon, IL 61021-1953 | 2010-06-22 |
| 1306814603 | Ksb Medical Group, Inc. | Eyewear Supplier (Equipment, not the service) | 102 S Hennepin Ave, Dixon, IL 61021-3083 | 2006-03-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174138168 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1550 W Lane Rd, Machesney Park, IL 61115-1903 | 2020-09-15 |
| 1588279566 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 1190 S Randall Rd Ste 104, Elgin, IL 60123-4110 | 2020-09-15 |
| 1972129294 | Luxottica Retail North America, Inc | Eyewear Supplier (Equipment, not the service) | 900 W North Ave, Chicago, IL 60642-2506 | 2020-06-23 |
| 1710512801 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 9940 Rt 47, Huntley, IL 60142 | 2020-03-09 |
| 1710512488 | Glasses On Oak St | Eyewear Supplier (Equipment, not the service) | 900 N Michigan Ave Fl 5, Chicago, IL 60611-1542 | 2020-03-03 |
| 1861026890 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 5300 Northwest Hwy, Crystal Lake, IL 60014-8072 | 2020-02-28 |
| 1952935181 | Jand. Inc. | Eyewear Supplier (Equipment, not the service) | 4999 Old Orchard Ctr Ste J4, Skokie, IL 60077-1450 | 2020-02-26 |
| 1194355917 | Fr Vision 360, Inc. | Eyewear Supplier (Equipment, not the service) | 111 E Morton Ave, Jacksonville, IL 62650-3059 | 2020-01-21 |
| 1114567443 | Shoptikal LLC | Eyewear Supplier (Equipment, not the service) | 6215 Northwest Hwy, Crystal Lake, IL 60014-7932 | 2020-01-15 |
| 1841833399 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | Milwaukee Ave & E Towline Rd #e1600, Vernon Hills, IL 60061 | 2019-10-28 |
| Find all providers with the same taxonomy | ||||
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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.