NORTHWESTERN MEDICAL FACULTY FOUNDATION (NPI# 1063821916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063821916 |
| Entity Type | Organization |
| Organization Name | NORTHWESTERN MEDICAL FACULTY FOUNDATION |
| Other Organization Name | NORTHWESTERN MEDICAL GROUP |
| Practice Address |
900 N Westmoreland Rd Lower Level 88 Lake Forest IL 60045-1674 |
| Mailing Address |
680 N Lake Shore Dr Suite#1000 Chicago IL 60611-4546 |
| Practice Telephone | 8472950001 |
| Mailing Telephone | 3129269797 |
| Mailing Fax Number | 3126950050 |
| Enumeration Date | 2014-08-05 |
| Last Update Date | 2014-11-04 |
| Authorized Official Name | MR. JUSTIN A. JOHNSON (VP,CFO) |
| Authorized Official Telephone | 3129261599 |
| Authorized Official Credential | 01041973 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152WC0802X |
Optometrist Specialization: Corneal and Contact Management |
Eye and Vision Services Providers | ||
| N | 152WV0400X |
Optometrist Specialization: Vision Therapy |
Eye and Vision Services Providers | ||
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| Other Name | Type Code |
|---|---|
| Northwestern Medical Group | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912516659 | Northwestern Medical Faculty Foundation | Optometrist | 2701 Patriot Blvd Fl 2, Glenview, IL 60026-8039 | 2020-07-29 |
| 1588063572 | Northwestern Medical Faculty Foundation | Optometrist | 259 E. Erie Street, Suite#02-220, Chicago, IL 60611-2661 | 2014-08-15 |
| 1497308340 | Northwestern Medical Faculty Foundation | Durable Medical Equipment & Medical Supplies | 675 N Saint Clair St Ste 20-150, Chicago, IL 60611-5979 | 2019-07-19 |
| 1316590409 | Northwestern Medical Faculty Foundation | Durable Medical Equipment & Medical Supplies | 2701 Patriot Blvd, Glenview, IL 60026-8039 | 2019-07-18 |
| 1467005520 | Northwestern Medical Faculty Foundation | Durable Medical Equipment & Medical Supplies | 800 N Westmoreland Rd Ste 100, Lake Forest, IL 60045-1671 | 2019-07-18 |
| 1801335690 | Northwestern Medical Faculty Foundation | Durable Medical Equipment & Medical Supplies | 675 N Saint Clair St, Suite 15-200, Chicago, IL 60611-5975 | 2017-02-14 |
| 1518324961 | Northwestern Medical Faculty Foundation | Durable Medical Equipment & Medical Supplies | 680 N Lake Shore Dr, Suite# 1000, Chicago, IL 60611-4546 | 2016-01-15 |
| 1770992448 | Northwestern Medical Faculty Foundation | Optometrist | 1475 E Belvidere Rd, Suite# 1297, Grayslake, IL 60030-2012 | 2014-08-07 |
| 1376961524 | Northwestern Medical Faculty Foundation | Durable Medical Equipment & Medical Supplies | 259 E Erie St, Suite 2300, Chicago, IL 60611-2987 | 2014-04-04 |
| 1912321621 | Northwestern Medical Faculty Foundation | Durable Medical Equipment & Medical Supplies | 737 N Michigan Ave, Suite#700, Chicago, IL 60611-2615 | 2014-02-17 |
| Street Address |
900 N WESTMORELAND RD LOWER LEVEL 88 |
| City | LAKE FOREST |
| State | IL |
| Zip Code | 60045-1674 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366437352 | Sheri Ross | Pediatrics | 900 N Westmoreland Rd, 106, Lake Forest, IL 60045-1674 | 2005-09-15 |
| 1982958013 | Pediatrust, L.L.C. | Pediatrics | 900 N Westmoreland Rd, Suite 217, Lake Forest, IL 60045-1674 | 2012-10-26 |
| 1891093019 | James E Jupa Md Sc | Internal Medicine | 900 N Westmoreland Rd, Suite 108, Lake Forest, IL 60045-1674 | 2011-03-11 |
| 1205083383 | Envision Eye Center Ltd | Durable Medical Equipment & Medical Supplies | 900 N Westmoreland Rd, Suite Ll84, Lake Forest, IL 60045-1681 | 2008-08-20 |
| 1265695530 | Kelsey Grimmer | Physician Assistant | 900 N Westmoreland Rd, Ste 222, Lake Forest, IL 60045-1674 | 2008-07-08 |
| 1780856799 | Elizabeth Q Wang | Nurse Practitioner | 900 N Westmoreland Rd, Suite 110, Lake Forest, IL 60045-1674 | 2008-03-31 |
| 1700060704 | Justin J. Cohen | Urology | 900 N Westmoreland Rd, Suite 228, Lake Forest, IL 60045-1674 | 2007-12-27 |
| 1710179759 | Karen J Mass | Obstetrics & Gynecology | 900 N Westmoreland Rd, Suite 223, Lake Forest, IL 60045-1674 | 2007-08-14 |
| 1417157835 | Rosamaria Slominski | Specialist | 900 N Westmoreland Rd, Basement, Lake Forest, IL 60045-1674 | 2007-07-23 |
| 1003011628 | Lake Shore Pediatrics, Ltd | Pediatrics | 900 N Westmoreland Rd, Suite 106, Lake Forest, IL 60045-1674 | 2007-06-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851931109 | Spine & Wellness Clinic, Inc. | Chiropractor | 775 N Bank Lane Suite 101, Lake Forest, IL 60045 | 2020-01-14 |
| 1184278640 | Mary Belluomini Dipietro | Dietitian, Registered | 1000 North Westmoreland Rd., Lake Forest, IL 60045 | 2019-08-01 |
| 1336621747 | Brook Elizabeth Orvis | Physical Therapist | 1000 N Westmoreland Road, 2nd Floor, Pavilion B, Lake Forest, IL 60045 | 2018-08-31 |
| 1336621028 | Michelle Nebel | Audiologist | 225 East Deerpath, Suite 223, Lake Forest, IL 60045 | 2018-08-30 |
| 1467951731 | Devan Keesling | Audiologist | 800 N Westmoreland Rd Ste Ll30, Lake Forest, IL 60045 | 2018-02-01 |
| 1023516796 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1000 N Westmoreland Rd Ste A, Lake Forest, IL 60045 | 2018-01-29 |
| 1275056780 | Karen Elizabeth Cohen | Counselor | 1331 S. Estate Lane, Lake Forest, IL 60045 | 2017-07-18 |
| 1497281711 | Caroline Connors | Speech-Language Pathologist | 660 Westmoreland Road, Lake Forest, IL 60045 | 2017-05-05 |
| 1013453406 | Katie L Konopacz | Nurse Practitioner | 1000 N Westmoreland Rd # B, Lake Forest, IL 60045 | 2017-01-10 |
| 1225424575 | Sean Robert Wessel | Internal Medicine | 1000 N Westmoreland Rd Ste 3556, Lake Forest, IL 60045 | 2015-04-14 |
| Find all providers in zip 60045 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| 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. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003205394 | Industrial Optical Service Inc. | Optometrist | 724 N Western Ave, Lake Forest, IL 60045-1820 | 2015-01-09 |
| 1861621484 | Horvath & Christensen Od Prof | Optometrist | 22681 Lake Forest Dr Ste A2, Lake Forest, CA 92630-1799 | 2009-07-02 |
| 1053576348 | Hillary Caryn Morrow | Optometrist | 224 E Westminster, Lake Forest, IL 60045-1840 | 2008-07-25 |
| 1619099769 | David Roy Tanouye | Optometrist | 25651 Atlantic Ocean Dr, Suite A-1, Lake Forest, CA 92630-8841 | 2007-04-06 |
| 1730216680 | Stephen Kay Christensen | Optometrist | 22681 Lake Forest Dr, Ste A-2, Lake Forest, CA 92630-1794 | 2007-02-27 |
| 1093851610 | Mary Melinda Wells | Optometrist | 23591 El Toro Road, Ste 145, Lake Forest, CA 92630 | 2007-01-30 |
| 1144313412 | John Celis, O.d., A Professional Corporation | Optometrist | 23600 Rockfield Blvd, Suite 3f, Lake Forest, CA 92630-1624 | 2006-10-01 |
| 1063437507 | Charles E Dominguez | Optometrist | 21098 Bake Pkwy, Suite 110, Lake Forest, CA 92630-2163 | 2006-07-13 |
| 1174576904 | Justin B Michaels | Optometrist | 23002 Lake Center Dr, Lake Forest, CA 92630-6801 | 2006-05-19 |
| 1548222169 | Kirk Stephen Roberts | Optometrist | 23811 Bridger Rd, Ste 110, Lake Forest, CA 92630 | 2006-04-06 |
| Find all providers in LAKE FOREST | ||||
| City | LAKE FOREST |
| Zip Code | 60045 |
Please comment or provide details below to improve the information on NORTHWESTERN MEDICAL FACULTY FOUNDATION.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.