Ralph Geiderman, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

IL046007178 Issued in IL

Practice address

3136 N Lincoln Ave
Chicago, IL 60657-3117

Phone

(773) 871-8210

Fax

(773) 871-4290

NPI assigned

Mar 29, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shoreland Optical Co #27 Inc.

  • Optometrist
  • Chicago, IL
  • NPI 1508986175
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073633681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3136 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573117",
            "telephone_number": "773-871-8210",
            "fax_number": "771-871-4290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3136 N LINCOLN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606573117",
            "telephone_number": "773-871-8210",
            "fax_number": "773-871-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEIDERMAN",
        "first_name": "RALPH",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "IL046007178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ted Gehrig
• Kayla Gehring
• Alyssa Gehrke
• Kenneth Gehrke, DDS
• Patrick A. Gehrlich, LCSW
• Justin Alexander Geier
• Steven Patrick Geiermann, D.D.S.
• Brett L Geiger, PHARMD
• Jennifer Geiger, LPC
• Kelsey Geiger

• Optometrist in Chicago, IL
• Providers in Chicago, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.