Individual provider Active NPI

Gloria Jean Docherty, O.D.

  • Optometrist
  • Orland Park, IL
National Provider Identifier
1083704282
Registry record updated Feb 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
15410 S Harlem Ave
Orland Park, IL 60462-4333
Phone
(708) 633-0060
Fax
(708) 633-0077
NPI assigned
Oct 16, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X IL Primary

Addresses

Primary practice location

15410 S Harlem Ave
Orland Park, IL 60462-4333

Mailing address

6504 Charleston St
Oak Forest, IL 60452-2623
Phone (708) 687-2522

Other identifiers 2

IdentifierTypeStateIssuer
0920080001OtherILMEDICARE DME
0040018663OtherILBCBS

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
I20080611000820 IL Practitioner - Optometry 1052482536 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orland Eye LTDGroup PAC ID 5597920173, 2 clinicians

Practice addresses (Care Compare)

15410 S Harlem Ave
Orland Park, IL 60462-4333
Phone (708) 633-0011

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orland Eye, LTD Optometrist CurrentSince Jun 15, 2012 Accepting new patients
Orland Eyeworks, LTD Optometrist PastSince Nov 21, 1994 Accepting new patients

Locations

15410 S Harlem Ave
Orland Park, IL 60462
Phone (708) 633-0011

Organizations & group practices 2

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": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203897600000",
    "number": "1083704282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6504 CHARLESTON ST",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604522623",
            "telephone_number": "708-687-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15410 S HARLEM AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624333",
            "telephone_number": "708-633-0060",
            "fax_number": "708-633-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOCHERTY",
        "first_name": "GLORIA",
        "middle_name": "JEAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2008-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "0920080001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0040018663",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.