Individual provider Active NPI

Cynthia Rae Logan, O.D.

  • Optometrist
  • Hoffman Estates, IL
National Provider Identifier
1053436006
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
3333 Beverly Rd
Sears Optical
Hoffman Estates, IL 60179-0001
Phone
(847) 286-7200
Fax
(847) 286-2246
NPI assigned
Mar 20, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X IL Primary

Addresses

Primary practice location

3333 Beverly Rd
Sears Optical
Hoffman Estates, IL 60179-0001

Mailing address

2713 Briargate CT
West Chicago, IL 60185-6431
Phone (630) 762-0274

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
I20111017000750 IL Practitioner - Optometry 4688846652 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-008781ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc. Optometrist CurrentSince Oct 27, 2014 Accepting new patients
Visionworks, Inc CurrentSince Oct 27, 2014 Accepting new patients
United Eye Care Providers, LLC Optometrist Past Accepting new patients
Central Dupage Vision Center Inc. Optometrist PastSince Jan 18, 2017 Accepting new patients

Locations

239 Golf Mill Ctr
Ste 255
Niles, IL 60714
Phone (847) 297-2286

2422 US Highway 34
Oswego, IL 60543
Phone (630) 551-4133

384 Randall Rd
South Elgin, IL 60177
Phone (847) 695-3354

19100 Ridgewood Pkwy
Bldg 1
San Antonio, TX 78259
Phone (726) 444-4069

Organizations & group practices 4

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": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053436006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2713 BRIARGATE CT",
            "city": "WEST CHICAGO",
            "state": "IL",
            "postal_code": "601856431",
            "telephone_number": "630-762-0274",
            "fax_number": "847-286-2246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 BEVERLY RD",
            "address_2": "SEARS OPTICAL",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601790001",
            "telephone_number": "847-286-7200",
            "fax_number": "847-286-2246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOGAN",
        "first_name": "CYNTHIA",
        "middle_name": "RAE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoffman Estates, IL

Sources for this page

Verify at the official NPI Registry.