Basic Information
Provider Information
NPI: 1942682208
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOPI
FirstName: EMILY
MiddleName: ROSE
NamePrefix: DR.
NameSuffix:  
Credential: O.D
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3711 W LAWRENCE AVE
Address2:  
City: CHICAGO
State: IL
PostalCode: 606255712
CountryCode: US
TelephoneNumber: 7735835727
FaxNumber:  
Practice Location
Address1: 1518 WALNUT ST
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641081338
CountryCode: US
TelephoneNumber: 8164741916
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/23/2015
LastUpdateDate: 02/18/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
152W00000X2015019901MOY Eye and Vision Services ProvidersOptometrist 

No ID Information.


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