Individual provider Active NPI

Austin William Toresdahl, OD

  • Optometrist
  • Oak Lawn, IL
National Provider Identifier
1013667211
Registry record updated Nov 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1319 Issued in ZZ
Practice address
6201 W 95TH St
Oak Lawn, IL 60453-3888
Phone
(708) 636-9393
Fax
(708) 636-2022
NPI assigned
Mar 28, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1319 ZZ Primary

Addresses

Primary practice location

6201 W 95TH St
Oak Lawn, IL 60453-3888

Mailing address

6201 W 95TH St
Oak Lawn, IL 60453-3888
Phone (708) 636-9393

Other practice location 1

820 S Damen Ave
Chicago, IL 60612-3728
Phone (403) 878-9956

Other practice location 2

68 W Dundee Rd
Buffalo Grove, IL 60089-3758
Phone (847) 541-3334

Other practice location 3

17W682 Butterfield Rd Ste 101
Oakbrook Terrace, IL 60181-4029
Phone (708) 636-9393

Other practice location 4

4459 N Kedzie Ave
Chicago, IL 60625-4785
Phone (773) 866-2020

Other practice location 5

14494 John Humphrey Dr
Orland Park, IL 60462-2638
Phone (708) 226-9393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1319ZZMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
20/20 Eye Physicians of Indiana P C Past Accepting new patients

Organizations & group practices 1

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": "1648425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669161600000",
    "number": "1013667211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6201 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533888",
            "telephone_number": "708-636-9393",
            "fax_number": "708-636-2022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604533888",
            "telephone_number": "708-636-9393",
            "fax_number": "708-636-2022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "820 S Damen Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606123728",
            "country_code": "US",
            "telephone_number": "403-878-9956",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "68 W Dundee Rd",
            "address_purpose": "LOCATION",
            "city": "Buffalo Grove",
            "state": "IL",
            "postal_code": "600893758",
            "country_code": "US",
            "telephone_number": "847-541-3334",
            "fax_number": "847-541-8442",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17W682 Butterfield Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Oakbrook Terrace",
            "state": "IL",
            "postal_code": "601814029",
            "country_code": "US",
            "telephone_number": "708-636-9393",
            "fax_number": "708-636-2022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4459 N Kedzie Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606254785",
            "country_code": "US",
            "telephone_number": "773-866-2020",
            "fax_number": "773-866-2022",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14494 John Humphrey Dr",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "604622638",
            "country_code": "US",
            "telephone_number": "708-226-9393",
            "fax_number": "708-403-5751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TORESDAHL",
        "first_name": "AUSTIN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-28",
        "last_updated": "2022-11-23",
        "certification_date": "2022-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "ZZ",
            "license": "1319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.