NPIMap

Organization Active NPI

Melrose Park Eye Care LLC

Doing business as Pearle Vision Melrose Park

  • Optometrist
  • Melrose Park, IL
National Provider Identifier
1073334595
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MELROSE PARK EYE CARE LLC
Doing business as
Pearle Vision Melrose Park
Practice address
904 W North Ave
Melrose Park, IL 60160-1520
Phone
(708) 343-9009
NPI assigned
Oct 17, 2024
Last updated
Oct 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Authorized official

Name
Tajal Patel Darne, ODNPI 1306038583
Title
Owner
Phone
(832) 607-2055

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 NU Primary

Addresses

Primary practice location

904 W North Ave
Melrose Park, IL 60160-1520

Mailing address

2501 Chatham Rd Ste R
Springfield, IL 62704-4188

Other names 1

  • PEARLE VISION MELROSE PARK Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250123002372 IL Part B Supplier - Clinic/Group Practice 6709315518 Receives reassigned benefits from 20 practitioners
Practice locations: Melrose Park, IL

National Provider Directory

National Provider Directory

Locations

904 W North Ave
Melrose Park, IL 60160
Phone (708) 343-6767

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1073334595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CHATHAM RD STE R",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 W NORTH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601520",
            "telephone_number": "708-343-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELROSE PARK EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "PATEL DARNE",
        "authorized_official_first_name": "TAJAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-607-2055",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEARLE VISION MELROSE PARK",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melrose Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; 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.