LUMEN OPTICAL ILLINOIS 4, LLC (NPI# 1700322922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1700322922 |
| Entity Type | Organization |
| Organization Name | LUMEN OPTICAL ILLINOIS 4, LLC |
| Practice Address |
2420 N Elston Bucktown IL 60647 |
| Practice Telephone | 8013165508 |
| Mailing Telephone | 8013165508 |
| Enumeration Date | 2017-01-11 |
| Last Update Date | 2017-01-11 |
| Authorized Official Name | BRENDON DEAN QUARNBERG (PRIVACY OFFICER) |
| Authorized Official Telephone | 8013165508 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152WP0200X |
Optometrist Specialization: Pediatrics |
Eye and Vision Services Providers | ||
| N | 152WV0400X |
Optometrist Specialization: Vision Therapy |
Eye and Vision Services Providers | ||
| N | 152WX0102X |
Optometrist Specialization: Occupational Vision |
Eye and Vision Services Providers | ||
| N | 156F00000X | Technician/Technologist | Eye and Vision Services Providers | ||
| N | 156FC0800X |
Technician/Technologist Specialization: Contact Lens |
Eye and Vision Services Providers | ||
| N | 156FC0801X |
Technician/Technologist Specialization: Contact Lens Fitter |
Eye and Vision Services Providers | ||
| N | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers | ||
| N | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers | ||
| Y | 152W00000X | Optometrist | Eye and Vision Services Providers |
| Street Address |
2420 N ELSTON |
| City | BUCKTOWN |
| State | IL |
| Zip Code | 60647 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164035879 | Scott Spine and Health LLC | Chiropractor | 2560 W. Armitage Ave, Unit C2, Chicago, IL 60647 | 2020-08-24 |
| 1003424458 | Emily Gleesing | Physical Therapist | 1923 N Western Ave, Chicago, IL 60647 | 2020-07-21 |
| 1699301358 | Marcella Guzman P.C. | Dentist | 3236 W. Fullerton Ave., Chicago, IL 60647 | 2020-03-13 |
| 1740772342 | Envision Unlimited | Case Management | 2646 N Washtenaw Ave # 3n, Chicago, IL 60647 | 2018-05-31 |
| 1992297535 | Envision Unlimited | Case Management | 2646 N Washtenaw Ave # 2n, Chicago, IL 60647 | 2018-05-30 |
| 1942704580 | Team Rehabilitation Il15, LLC | Physical Therapist | 1923 N Western Avenue, Chicago, IL 60647 | 2018-03-20 |
| 1023517331 | Chicago Medical Healthcare Group, S.c. | Family Medicine | 3648 W Armitage Avenue, Chicago, IL 60647 | 2018-02-02 |
| 1023537693 | Erin Frommeyer | Physician Assistant | 2228 W Dickens Avenue, Chicago, IL 60647 | 2017-09-15 |
| 1457872475 | Stefanie Paola Maurtua | Behavioral Analyst | 2448 West Bloomingdale Ave., Apt 2e, Chicago, IL 60647 | 2017-06-29 |
| 1407302110 | Jasmine Swanigan | Home Health Aide | 2753 W North Ave, Floor 3, Chicago, IL 60647 | 2016-09-01 |
| Find all providers in zip 60647 | ||||
| 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 |
|---|---|---|---|---|
| 1437750247 | Saida Samedova | Optometrist | 5255 Il-251, Peru, IL 61354 | 2020-11-06 |
| 1124627880 | Biren Patel | Optometrist | 1330 N Larkin Ave, Joliet, IL 60435-3765 | 2020-10-22 |
| 1790392587 | Adriana Casillas | Optometrist | 11129 S Avenue J, Chicago, IL 60617-6910 | 2020-09-25 |
| 1033725114 | Sabrina D'haiti | Optometrist | 607 Oakton St, Evanston, IL 60202-5615 | 2020-09-23 |
| 1164037495 | Brett David Freitag | Optometrist | 5006 Northwest Hwy, Crystal Lake, IL 60014-7339 | 2020-09-14 |
| 1164036786 | Deeti Patel | Optometrist | 9053 Hollyberry Ave, Des Plaines, IL 60016-4216 | 2020-09-01 |
| 1497368252 | Gca Optical LLC | Optometrist | 1520 N Rock Run Dr Ste 2, Crest Hill, IL 60403-3172 | 2020-08-30 |
| 1538778097 | Opt Vision | Optometrist | 5371 W Lawrence Ave Ste A, Chicago, IL 60630-3695 | 2020-07-30 |
| 1578180147 | Ortizii PC | Optometrist | 111 N Wabash Ave Ste 1111, Chicago, IL 60602-3119 | 2020-06-30 |
| 1053938092 | Premier Vision Center LLC | Optometrist | 2809 Mansion Rd Ste A, Springfield, IL 62711-6811 | 2020-06-25 |
| Find all providers with the same taxonomy | ||||
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| 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.