Individual provider Active NPI

Carolyn Dienes, OD

  • Optometrist
  • Downers Grove, IL
National Provider Identifier
1013391077
Registry record updated Dec 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010862 Issued in IL
Practice address
1412 Butterfield Rd
Downers Grove, IL 60515-1031
Phone
(630) 627-3001
Fax
(630) 627-3021
NPI assigned
Jul 18, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18003909A IN
Optometrist 152W00000X 046010862 IL Primary

Addresses

Primary practice location

1412 Butterfield Rd
Downers Grove, IL 60515-1031

Mailing address

7200 Harrison Ave # U265
Rockford, IL 61112-1017

Other practice location 1

7200 Harrison Ave # U265
Rockford, IL 61112-1017
Phone (815) 332-2223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160318000449 IL Practitioner - Optometry 2668779687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pennsylvania College of Optometry, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Town Eye Care of Downers Grove IncGroup PAC ID 4880802032, 2 clinicians

Practice addresses (Care Compare)

1404 Butterfield Rd
Downers Grove, IL 60515-1031
Phone (630) 627-3001

1412 Butterfield Rd
Downers Grove, IL 60515-1031

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046010862ILMDOptometrist
18003909AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Town Eye Care of Downers Grove Inc Optometrist CurrentSince Jan 1, 2022 Accepting new patients
Vincent Facchiano and Associates Optometrist Past Accepting new patients

Locations

1404 Butterfield Rd
Downers Grove, IL 60515
Phone (630) 627-3001

1412 Butterfield Rd
Downers Grove, IL 60515
Phone (630) 627-3001

Networks

  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806
  • IL PPO Downstate
  • IL HMO C-SNP
  • devoted network organization-27eb9117-6975-449a-a7ad-909243995ddc
  • devoted network organization-734447cc-691b-4aa7-a112-9c9c8698dcc9

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638835200000",
    "number": "1013391077",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7200 HARRISON AVE # U265",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611121017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1412 BUTTERFIELD RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151031",
            "telephone_number": "630-627-3001",
            "fax_number": "630-627-3021"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7200 Harrison Ave # U265",
            "address_purpose": "LOCATION",
            "city": "Rockford",
            "state": "IL",
            "postal_code": "611121017",
            "country_code": "US",
            "telephone_number": "815-332-2223",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIENES",
        "first_name": "CAROLYN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-18",
        "last_updated": "2021-12-07",
        "certification_date": "2021-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18003909A",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010862",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.