Jasper Gulotta
Optometrist in South Holland, IL. Organization (NPI-2).
NPI number1497937403
StatusActive
Last updated in NPPESAug 28, 2009
Details
- NPI
- 1497937403
- Entity type
- Organization (NPI-2)
- Legal business name
- Jasper Gulotta
- Organization subpart
- No
- Enumeration date
- Nov 30, 2007
- Last updated
- Aug 28, 2009
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 152W00000X | Optometrist | – | – | Yes |
| 332H00000X | Eyewear Supplier (Equipment, not the service) | – | – |
Other names
- South Holland Optometric Associates (Doing Business As)
Practice location
835 E 162nd StSouth Holland, IL 60473-2465
Phone 708-333-4444 · Fax 708-333-4454
Mailing address
835 E 162nd StSouth Holland, IL 60473-2465
Phone 708-333-4444 · Fax 708-333-4454
Authorized official
Jasper Jay Gulotta
Owner
7083334444
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Other Optometrist providers in South Holland, IL
- Advanced Eyecare South Holland Od And Associates PCNPI 1942749791
- Dr. Stephen Shulman, P.C.NPI 1629206933
- Jasper J Gulotta, O.D.NPI 1669464251
- Lw Vision IncorporatedNPI 1194960492
- Divya Patel, ODNPI 1831935055
- Lonnie Lee Williams, ODNPI 1225045669
All 7 Optometrist providers in South Holland · All 577 providers in South Holland
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