Individual provider Active NPI

Dennis H Ireland, OD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1053304402
Registry record updated Aug 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046006539 Issued in IL
Practice address
3241 S Michigan Ave
Chicago, IL 60616-3849
Phone
(312) 225-6200
Fax
(312) 949-7660
NPI assigned
Aug 31, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046006539 IL Primary

Addresses

Primary practice location

3241 S Michigan Ave
Chicago, IL 60616-3849

Mailing address

7777 Lake St
Suite 111
River Forest, IL 60305-1734
Phone (708) 771-0500

Other identifiers 1

IdentifierTypeStateIssuer
046006539MedicaidIL

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
I20100605000059 IL Practitioner - Optometry 9335279199 Reassigns benefits to 1 organization
Practice locations: Crestwood, IL; River Forest, IL; Palos Heights, IL; Frankfort, IL; Bourbonnais, IL

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1973
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Illinois College of OptometryGroup PAC ID 7416851639, 77 clinicians

Practice addresses (Care Compare)

3241 S Michigan Ave
Chicago, IL 60616-3878
Phone (312) 949-7751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois College of Optometry Optometrist CurrentSince Jun 1, 1997 Accepting new patients

Locations

3241 S Michigan Ave
Chicago, IL 60616
Phone (312) 225-6200

14255 Cicero Ave
Crestwood, IL 60418
Phone (708) 371-0400

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: dennis.ireland.iei@direct.ico.nextgenshare.com

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, 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": "1125446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375920000000",
    "number": "1053304402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 LAKE ST",
            "address_2": "SUITE 111",
            "city": "RIVER FOREST",
            "state": "IL",
            "postal_code": "603051734",
            "telephone_number": "708-771-0500",
            "fax_number": "708-771-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3241 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163849",
            "telephone_number": "312-225-6200",
            "fax_number": "312-949-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRELAND",
        "first_name": "DENNIS",
        "middle_name": "H",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-31",
        "last_updated": "2013-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046006539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046006539",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.