Craig Matthew Declark, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046007272 Issued in IL

Practice address

6336 W Gunnison St
Chicago, IL 60630-2954

Phone

(773) 763-4666

Fax

(773) 763-4967

NPI assigned

Aug 17, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1979

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Craig M. Declark, O.D.,P.C.

  • Optometrist
  • Chicago, IL
  • NPI 1295855385

  IL, Optometrist

  Medicare reassignment NPD Authorized official
• United Eye Care Providers, LLC

  • Optometrist
  • Lemont, IL
  • NPI 1013070093
  NPD (past)

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

{
    "created_epoch": "1124236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211241600000",
    "number": "1033101993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6336 W GUNNISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302954",
            "telephone_number": "773-763-4666",
            "fax_number": "773-763-4967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6336 W GUNNISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606302954",
            "telephone_number": "773-763-4666",
            "fax_number": "773-763-4967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DECLARK",
        "first_name": "CRAIG",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-17",
        "last_updated": "2008-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genevieve Decker, DNP. AGACNP-BC
• Nicole Decker, OD
• Paul Xavier Decker, M.D.
• Victoria Lynn Decker
• Jay Declarador
• Michelle Decola
• Anne Kirsti Decore, LMFT
• Nancy C Decorrevant, CRNA
• Helene Decourchelle, MT
• Nicole Elizabeth Decredico, M.D.

• Optometrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.