Individual provider Active NPI

Kristopher Mark Owens, O.D.

  • Optometrist
  • Naperville, IL
National Provider Identifier
1023110483
Registry record updated Nov 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-009091 Issued in IL
Practice address
3124 S Route 59
Suite 116
Naperville, IL 60564-8032
Phone
(630) 388-0606
Fax
(630) 388-0610
NPI assigned
Sep 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-009091 IL Primary

Addresses

Primary practice location

3124 S Route 59
Suite 116
Naperville, IL 60564-8032

Mailing address

3124 S Route 59
Suite 116
Naperville, IL 60564-8032
Phone (630) 388-0606

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
I20051004000472 IL Practitioner - Optometry 1850326356 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rosin Optical Co IncGroup PAC ID 8022921758, 51 clinicians

Practice addresses (Care Compare)

6233 Cermak Rd
Berwyn, IL 60402-2317
Phone (708) 749-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-009091ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Rosin Optical Co., Inc Optometrist Current Accepting new patients
Rosin Optical Co., Inc. CurrentSince May 1, 2016 Accepting new patients
Rosin Optical Co. Inc. Optometrist CurrentSince May 1, 2016 Accepting new patients
Rosin Optical Co., Inc. Optometrist Past Accepting new patients
Rosin Optical Co., Inc. Past Accepting new patients

Locations

6235 Cermak Rd
Berwyn, IL 60402
Phone (708) 749-2020

145 Ogden Ave
Downers Grove, IL 60515
Phone (630) 749-2020

3124 S Route 59
Naperville, IL 60564
Phone (630) 388-0606

3124 S Route 59
Ste 116
Naperville, IL 60564
Phone (630) 388-0606

1706 E Roosevelt Rd
Wheaton, IL 60187
Phone (630) 653-8885

Organizations & group practices 5

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": "1157414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1480464000000",
    "number": "1023110483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3124 S ROUTE 59",
            "address_2": "SUITE 116",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648032",
            "telephone_number": "630-388-0606",
            "fax_number": "630-388-0610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3124 S ROUTE 59",
            "address_2": "SUITE 116",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605648032",
            "telephone_number": "630-388-0606",
            "fax_number": "630-388-0610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OWENS",
        "first_name": "KRISTOPHER",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-05",
        "last_updated": "2016-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

Verify at the official NPI Registry.