Individual provider Active NPI

Dennis W Kirscher, O.D.

  • Optometrist
  • Homer Glen, IL
National Provider Identifier
1083604177
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-006743 Issued in IL
Practice address
13231 W 143Rd St
Suite 101
Homer Glen, IL 60491-6638
Phone
(708) 301-2020
Fax
(708) 301-0884
NPI assigned
Oct 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-006743 IL Primary

Addresses

Primary practice location

13231 W 143Rd St
Suite 101
Homer Glen, IL 60491-6638

Mailing address

1112 S Washington St
Ste 214
Naperville, IL 60540-7964
Phone (708) 301-2020

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
I20101116000643 IL Practitioner - Optometry 0244425296 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1975
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1112 S Washington St
Suite 214
Naperville, IL 60540-7964

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-006743ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Michael S Russell, OD, LLC Optometrist CurrentSince Jul 14, 2021 Accepting new patients
Comprehensive Eyecare Physicians PC PastSince Sep 16, 2002 Accepting new patients
Illinois College of Optometry Optometrist PastSince Aug 8, 2014 Accepting new patients
Richard F Butz PastSince Aug 8, 2014 Accepting new patients

Locations

1112 S Washington St
Ste 201
Naperville, IL 60540
Phone (630) 355-6878

1112 S Washington St
Ste 214
Naperville, IL 60540
Phone (630) 355-6878

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 4

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": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1083604177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 S WASHINGTON ST",
            "address_2": "STE 214",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605407964",
            "telephone_number": "708-301-2020",
            "fax_number": "708-301-0884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13231 W 143RD ST",
            "address_2": "SUITE 101",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604916638",
            "telephone_number": "708-301-2020",
            "fax_number": "708-301-0884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KIRSCHER",
        "first_name": "DENNIS",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2021-10-12",
        "certification_date": "2021-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-006743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer Glen, IL

Sources for this page

Verify at the official NPI Registry.