SHOPKO OPTICAL 119
NPI 1700838729
Eyewear Supplier in Dixon, IL

Q: What is Shopko Stores Operating Co. LLC's NPI number?

The NPI number for Shopko Stores Operating Co. LLC is 1700838729. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 119.

Q: What is Shopko Stores Operating Co. LLC's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

Active since May 17, 2006

1350 N GALENA AVE, DIXON, IL 61021(815) 284-3935 Get Directions Write a Review

NPPES record last updated: June 4, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Shopko Optical 119 NPPES

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

SHOPKO OPTICAL 119 (NPI 1700838729) is a healthcare organization registered as an eyewear supplier in Dixon, Illinois and active in the NPI registry since May 2006. The organization lists Michael J Bettiga, Sr. Vice President Health Services, as its authorized official.

NPPES Registry Identity

NPI1700838729

Entity TypeOrganization

Primary Taxonomy332H00000X

Legal Business NameSHOPKO STORES OPERATING CO. LLC

Location Address1350 N GALENA AVEDixon, IL 61021-1010

Mailing Address1350 N Galena AveDixon, IL 61021-1010 · (815) 284-3935

Phone(815) 284-3935

Organization SubpartNo

Authorized OfficialMichael J BettigaSr. Vice President Health Services · (920) 429-4297

Enumeration DateMay 17, 2006

Last NPPES UpdateJune 4, 2008

✔ NPI 1700838729 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyEyewear SupplierSuppliers

Taxonomy Code332H00000X

Definition

An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.

1350 N GALENA AVE, Dixon, IL 61021

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Other Names 1

Doing Business AsShopko Optical 119

Other Identifiers 9

Medicare PIN213638

OtherCP2230-13Eyemed

Medicare PINDF0851

Other17683Medicare

Other014119Vip

Other42531Davis

Medicare NSC5695760131IL

Other5232016IL · Bcbs Il

Medicare ID-Type Unspecified0154160211

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. THOMAS KENNETH BIALECKE OD

Optometrist

1350 N GALENA AVE
DIXON, IL 61021

Lee County (815) 284-3935

SHOPKO STORES OPERATING CO LLC

Pharmacy (Community/Retail Pharmacy)

1350 N GALENA AVE
DIXON, IL 61021

Lee County (815) 284-4127

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 Shopko Stores Operating Co. LLC's NPI number?

The NPI number for Shopko Stores Operating Co. LLC is 1700838729. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 119.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 1350 N Galena Ave, Dixon, IL 61021. The listed phone number is (815) 284-3935.

What is Shopko Stores Operating Co. LLC's specialty?

The primary specialty registered for this NPI is Eyewear Supplier with taxonomy code 332H00000X.

When was this NPI record last updated?

The NPPES record for Shopko Stores Operating Co. LLC was last updated on June 4, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.