Active NPI
Nelly Kamenetsky, O.D.
- Optometrist
- Skokie, IL
National Provider Identifier
1063700086
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046010444
- Practice address
- 7151 Central Ave
Skokie, IL 60077-3275 - Phone
- (847) 674-6666
- NPI assigned
- Jul 11, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046010444 | IL | Primary |
Addresses
Primary practice location
7151 Central Ave
Skokie, IL 60077-3275
Mailing address
7151 Central Ave
Skokie, IL 60077-3275
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046010444 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Village Crossing Optical | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Point of Service
- Skokie, IL
- NPI 1790994358
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1310342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1310342400000",
"number": "1063700086",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7151 CENTRAL AVE",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600773275"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7151 CENTRAL AVE",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600773275",
"telephone_number": "847-674-6666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KAMENETSKY",
"first_name": "NELLY",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-07-11",
"last_updated": "2011-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046010444",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Skokie, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.