Individual provider Active NPI

Sean C Oneill, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1083770341
Registry record updated Sep 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009017 Issued in IL
Practice address
100 W Randolph St Uppr 104
Chicago, IL 60601-3219
Phone
(312) 263-4909
Fax
(312) 263-4932
NPI assigned
Dec 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009017 IL Primary

Addresses

Primary practice location

100 W Randolph St Uppr 104
Chicago, IL 60601-3219

Mailing address

100 W Randolph St Uppr 104
Chicago, IL 60601-3219
Phone (312) 263-4909

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
I20040120000470 IL Practitioner - Optometry 7113828096 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009017ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc. Optometrist CurrentSince May 20, 2019 Accepting new patients
Visionworks, Inc CurrentSince May 20, 2019 Accepting new patients
Crystal Lake Optical Inc. Optometrist Past Accepting new patients

Locations

6170 Grand Ave
Ste 375
Gurnee, IL 60031
Phone (847) 645-0136

239 Golf Mill Ctr
Ste 255
Niles, IL 60714
Phone (847) 297-2286

2422 US Highway 34
Oswego, IL 60543
Phone (630) 551-4133

19100 Ridgewood Pkwy
Bldg 1
San Antonio, TX 78259
Phone (726) 444-4069

Organizations & group practices 3

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": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252368000000",
    "number": "1083770341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 W RANDOLPH ST UPPR 104",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606013219",
            "telephone_number": "312-263-4909",
            "fax_number": "312-263-4932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 W RANDOLPH ST UPPR 104",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606013219",
            "telephone_number": "312-263-4909",
            "fax_number": "312-263-4932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ONEILL",
        "first_name": "SEAN",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2009-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009017",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.