Organization Active NPI

Holmberg Optometric LTD

Doing business as Greenspan Optometric Assocoiates

  • Optometrist
  • Chicago Heights, IL
National Provider Identifier
1073027348
Registry record updated Jan 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-010888 Issued in IL
Legal business name
HOLMBERG OPTOMETRIC LTD
Doing business as
Greenspan Optometric Assocoiates
Practice address
366 Dixie Hwy
Chicago Heights, IL 60411-1758
Phone
(708) 754-0080
Fax
(708) 754-0089
NPI assigned
Nov 25, 2017
Last updated
Jan 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2018

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

Authorized official

Name
Dr. Kathrine L Holmberg, ODNPI 1427427418
Title
Owner
Phone
(708) 754-0080

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-010888 IL Primary

Addresses

Primary practice location

366 Dixie Hwy
Chicago Heights, IL 60411-1758

Mailing address

366 Dixie Hwy
Chicago Heights, IL 60411-1758
Phone (708) 754-0080

Other names 1

  • Greenspan Optometric Assocoiates Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180201001794 IL Part B Supplier - Clinic/Group Practice 4284994724 Receives reassigned benefits from 4 practitioners
Practice locations: Chicago Heights, IL

National Provider Directory

National Provider Directory

Locations

366 Dixie Hwy
Chicago Hts, IL 60411
Phone (708) 754-0080

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1511568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517270400000",
    "number": "1073027348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 DIXIE HWY",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604111758",
            "telephone_number": "708-754-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 DIXIE HWY",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604111758",
            "telephone_number": "708-754-0080",
            "fax_number": "708-754-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLMBERG OPTOMETRIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-25",
        "last_updated": "2018-01-30",
        "status": "A",
        "authorized_official_last_name": "HOLMBERG",
        "authorized_official_first_name": "KATHRINE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "708-754-0080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-010888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greenspan Optometric Assocoiates",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2018; 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.