Individual provider Active NPI

Charles Hoang, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1073514485
Registry record updated Oct 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009175 Issued in IL
Practice address
150 N Michigan Ave
Ste. 650
Chicago, IL 60601-7553
Phone
(312) 372-7571
Fax
(312) 372-7358
NPI assigned
Aug 9, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009175 IL Primary

Addresses

Primary practice location

150 N Michigan Ave
Ste. 650
Chicago, IL 60601-7553

Mailing address

416 N Ridgeland Ave
Elmhurst, IL 60126-2218
Phone (312) 498-1755

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
I20080118000441 IL Practitioner - Optometry 6103907845 Reassigns benefits to 1 organization
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009175ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kovach Eye Institute, LTD CurrentSince Feb 26, 2018 Accepting new patients

Locations

150 N Michigan Ave
Ste 650
Chicago, IL 60601
Phone (312) 372-7271

152 N Addison Ave
Elmhurst, IL 60126
Phone (630) 833-9621

152 N Addison Ave
Fl 1
Elmhurst, IL 60126
Phone (630) 833-9621

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.

NPI Registry JSON

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

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477440000000",
    "number": "1073514485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "416 N RIDGELAND AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262218",
            "telephone_number": "312-498-1755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N MICHIGAN AVE",
            "address_2": "STE. 650",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017553",
            "telephone_number": "312-372-7571",
            "fax_number": "312-372-7358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOANG",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-09",
        "last_updated": "2016-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.