DR. JAY CHARLES BLACK OD
NPI 1629113261
Optometrist in Loves Park, IL

Q: What is Jay Black's NPI number?

The NPI number for Jay Black is 1629113261. It was assigned to this individual provider in the NPPES registry on February 21, 2007.

Q: What is Jay Black's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Q: When was this NPI record last updated?

The NPPES record for Jay Black was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 21, 2007

5316 N SECOND STREET, LOVES PARK, IL 61111(815) 877-6551(815) 877-4821 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Jay Charles Black Od NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JAY CHARLES BLACK OD (NPI 1629113261) is an individual optometrist in Loves Park, Illinois, licensed in Illinois (466709) and active in the NPI registry since February 2007.

NPPES Registry Identity

NPI1629113261

Entity TypeIndividualMale

Primary Taxonomy152W00000X

Provider Legal NameDR. JAY CHARLES BLACKCredential: OD

Location Address5316 N SECOND STREETLoves Park, IL 61111-5009

Mailing Address5316 N Second StreetLoves Park, IL 61111-5009 · (815) 877-6551 · Fax (815) 877-4821

Phone(815) 877-6551

Fax(815) 877-4821

Sole ProprietorNo

Enumeration DateFebruary 21, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1629113261 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers

Taxonomy Code152W00000X

License✔ Licensed in IL · 466709

Definition

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.

5316 N SECOND STREET, Loves Park, IL 61111

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Other Identifiers 2

Medicare ID-Type Unspecified250730

Medicare UPINT35605

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jay Black's NPI number?

The NPI number for Jay Black is 1629113261. It was assigned to this individual provider in the NPPES registry on February 21, 2007.

Where is Jay Black located?

Jay Black practices at 5316 N Second Street, Loves Park, IL 61111. The listed phone number is (815) 877-6551.

What is Jay Black's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

When was this NPI record last updated?

The NPPES record for Jay Black was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.