Active NPI
Eye Surgeons SC
- Ophthalmology Physician
- Chicago, IL
National Provider Identifier
1003949777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Legal business name
- EYE SURGEONS SC
- Practice address
- 5330 W Devon Ave
Chicago, IL 60646-4108 - Phone
- (773) 775-4947
- Fax
- (773) 775-5109
- NPI assigned
- Mar 13, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Irene Stoepler
- Title
- Secretary
- Phone
- (773) 743-4300
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | IL | Primary |
Addresses
Primary practice location
5330 W Devon Ave
Chicago, IL 60646-4108
Mailing address
5330 W Devon Ave
Chicago, IL 60646-4108
Phone (773) 775-4947
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20100525000787 | IL | Part B Supplier - Clinic/Group Practice | 2860521168 |
Receives reassigned benefits from 2 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Chicago, IL |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryLocations
5330 W Devon Ave
Chicago, IL 60646
Phone (312) 774-3515
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1003949777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5330 W DEVON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606464108",
"telephone_number": "773-775-4947",
"fax_number": "773-775-5109"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5330 W DEVON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606464108",
"telephone_number": "773-775-4947",
"fax_number": "773-775-5109"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EYE SURGEONS SC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-13",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "STOEPLER",
"authorized_official_first_name": "IRENE",
"authorized_official_title_or_position": "SECRETARY",
"authorized_official_telephone_number": "773-743-4300"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": "IL",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.