Organization Active NPI

Midwest Eye, P.C.

  • Optometrist
  • Westchester, IL
National Provider Identifier
1043589963
Registry record updated Dec 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MIDWEST EYE, P.C.
Practice address
10215 W Roosevelt Rd
Westchester, IL 60154-2576
Phone
(708) 345-7005
Fax
(708) 345-7043
NPI assigned
Dec 21, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 21, 2011

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

Authorized official

Name
Dr. Todd Robert
Title
President
Phone
(708) 345-7005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

10215 W Roosevelt Rd
Westchester, IL 60154-2576

Mailing address

10215 W Roosevelt Rd
Westchester, IL 60154-2576
Phone (708) 345-7005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120917000174 IL Part B Supplier - Clinic/Group Practice 8729236773 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Downers Grove, IL

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1324425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1324425600000",
    "number": "1043589963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10215 W ROOSEVELT RD",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601542576",
            "telephone_number": "708-345-7005",
            "fax_number": "708-345-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10215 W ROOSEVELT RD",
            "city": "WESTCHESTER",
            "state": "IL",
            "postal_code": "601542576",
            "telephone_number": "708-345-7005",
            "fax_number": "708-345-7043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST EYE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-21",
        "last_updated": "2011-12-21",
        "status": "A",
        "authorized_official_last_name": "ROBERT",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-345-7005",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westchester, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.