Eyes on Elburn LTD LLC

Primary specialty

OptometristTaxonomy code 152W00000X

License

046009169 Issued in IL

Legal business name

EYES ON ELBURN LTD LLC

Practice address

135 S Main St
Unit 4
Elburn, IL 60119-9108

Phone

(630) 365-5225

Fax

(630) 365-5240

NPI assigned

Nov 5, 2008

Organization subpart

No

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

Authorized official

Name

Keith Hougas, O.D.NPI 1437274297

Title

President

Phone

(630) 365-5225

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keith E. Hougas, O.D.

  • Optometrist
  • Elburn, IL
  • NPI 1437274297

  IL, Optometrist

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1225843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354752000000",
    "number": "1073767950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S MAIN ST",
            "address_2": "UNIT 4",
            "city": "ELBURN",
            "state": "IL",
            "postal_code": "601199108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 S MAIN ST",
            "address_2": "UNIT 4",
            "city": "ELBURN",
            "state": "IL",
            "postal_code": "601199108",
            "telephone_number": "630-365-5225",
            "fax_number": "630-365-5240"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYES ON ELBURN LTD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-05",
        "last_updated": "2012-12-06",
        "status": "A",
        "authorized_official_last_name": "HOUGAS",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-365-5225",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr. Tom Dentistry Elburn, PC
• Nicole Dulski, RN
• Amanda Durbin, PHARM D
• Elburn & Countryside Fire Protection District
• Elburn Health Associates, S.C.
• Dawn Ilene Faulkner, OTR/L
• David Lin Foss, D.C.
• Kristy Ellen Gibson, M.A., CCC-SLP
• Loren M Gineris, PT
• Gliddons Drug Store Inc

• All providers in Elburn, IL
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2012; 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.