Active NPI
Gary G. Hauser, O.D.
- Optometrist
- Chicago, IL
National Provider Identifier
1023016870
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046-007459
- Practice address
- 3125 S Ashland Ave
Suite 204
Chicago, IL 60608-6252 - Phone
- (773) 890-1100
- NPI assigned
- Jul 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046-007459 | IL | Primary |
Addresses
Primary practice location
3125 S Ashland Ave
Suite 204
Chicago, IL 60608-6252
Mailing address
3125 S Ashland Ave
Suite 204
Chicago, IL 60608-6252
Phone (773) 890-1100
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 410041869 | Other | RAILROAD MEDICARE | |
| 046007459 | Medicaid | IL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 046-007459 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bridgeport Eye Care, LLC | Optometrist | Current | Accepting new patients |
Locations
3125 S Ashland Ave
Ste 204
Chicago, IL 60608
Phone (773) 890-1100
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": "1121212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1227225600000",
"number": "1023016870",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3125 S ASHLAND AVE",
"address_2": "SUITE 204",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606086252",
"telephone_number": "773-890-1100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3125 S ASHLAND AVE",
"address_2": "SUITE 204",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606086252",
"telephone_number": "773-890-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAUSER",
"first_name": "GARY",
"middle_name": "G.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-13",
"last_updated": "2008-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046-007459",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "410041869",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "046007459",
"state": "IL"
}
],
"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 Nov 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.