SHOPKO OPTICAL 125
NPI 1811949803
Eyewear Supplier in Freeport, IL

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

The NPI number for Shopko Stores Operating Co. LLC is 1811949803. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 125.

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

555 W SOUTH ST, FREEPORT, IL 61032(815) 232-3057 Get Directions Write a Review

NPPES record last updated: June 4, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Shopko Optical 125 NPPES

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

SHOPKO OPTICAL 125 (NPI 1811949803) is a healthcare organization registered as an eyewear supplier in Freeport, 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

NPI1811949803

Entity TypeOrganization

Primary Taxonomy332H00000X

Legal Business NameSHOPKO STORES OPERATING CO. LLC

Location Address555 W SOUTH STFreeport, IL 61032-6792

Mailing Address555 W South StFreeport, IL 61032-6792 · (815) 232-3057

Phone(815) 232-3057

Organization SubpartNo

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

Enumeration DateMay 17, 2006

Last NPPES UpdateJune 4, 2008

✔ NPI 1811949803 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.

555 W SOUTH ST, Freeport, IL 61032

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Other Names 1

Doing Business AsShopko Optical 125

Other Identifiers 10

Other5232016IL · Bcbs Il

Medicare PIN213638

OtherCP2230-15Eyemed

Other35455Avesis

Other42542Davis

Other17684Medicare

Other014125Vip

Medicare ID-Type Unspecified0154160229

Medicare NSC5695760136IL

Medicare PINDF0851

Other Providers at the Same Location NPPES 3

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

BARBARA L FELGENHAUER FNP-BC

Nurse Practitioner (Family)

555 W SOUTH ST
FREEPORT, IL 61032

Stephenson County (815) 599-7801

SHOPKO STORES OPERATING CO LLC

Pharmacy (Community/Retail Pharmacy)

555 W SOUTH ST
FREEPORT, IL 61032

Stephenson County (815) 232-2724

DR. DAVID J ANDERSON O.D.

Optometrist

555 W SOUTH ST
FREEPORT, IL 61032

Stephenson County (815) 232-3057

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 1811949803. It was assigned to this organization in the NPPES registry on May 17, 2006. The provider is doing business as Shopko Optical 125.

Where is Shopko Stores Operating Co. LLC located?

Shopko Stores Operating Co. LLC is located at 555 W South St, Freeport, IL 61032. The listed phone number is (815) 232-3057.

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.