Individual provider Active NPI

Diana Yin, OD

  • Optometrist
  • Lake Bluff, IL
National Provider Identifier
1023501483
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011284 Issued in IL
Practice address
207 N Waukegan Rd
Lake Bluff, IL 60044
Phone
(224) 524-1011
NPI assigned
Jun 11, 2018
Last updated
Apr 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046011284 IL Primary

Addresses

Primary practice location

207 N Waukegan Rd
Lake Bluff, IL 60044

Mailing address

1081 Oak Spring LN
Libertyville, IL 60048-1613
Phone (815) 501-7419

Other practice location 1

730 N Milwaukee Ave
Libertyville, IL 60048-1914
Phone (847) 362-9900

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
I20241125001430 IL Practitioner - Optometry 0749715993 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Pacific University - College of Optometry, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

207 Waukegan Rd
Lake Bluff, IL 60044-1666
Phone (224) 524-1011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046011284ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Forest Bluff Optometry LLC Optometrist CurrentSince Jul 14, 2025 Accepting new patients
730 North Optometry PC Optometrist CurrentSince Nov 19, 2024 Accepting new patients
Brain-Eye Evolution at 730 North PastSince Mar 1, 2022 Accepting new patients

Locations

207 Waukegan Rd
Lake Bluff, IL 60044
Phone (224) 524-1011

730 N Milwaukee Ave
Libertyville, IL 60048
Phone (847) 362-9900

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1528675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1023501483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1081 OAK SPRING LN",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481613",
            "telephone_number": "815-501-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 N WAUKEGAN RD",
            "city": "LAKE BLUFF",
            "state": "IL",
            "postal_code": "60044",
            "telephone_number": "224-524-1011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "730 N Milwaukee Ave",
            "address_purpose": "LOCATION",
            "city": "Libertyville",
            "state": "IL",
            "postal_code": "600481914",
            "country_code": "US",
            "telephone_number": "847-362-9900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "YIN",
        "first_name": "DIANA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-11",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011284",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Bluff, IL

Sources for this page

Verify at the official NPI Registry.