Active NPI
Cassandra Anne Koutnik, O.D.
- Optometrist
- Chicago, IL
National Provider Identifier
1093190019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046.010904
- Practice address
- 2121 W Division St
Chicago, IL 60622-2948 - Phone
- (773) 697-7370
- NPI assigned
- Jul 21, 2015
- Last updated
- Feb 17, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046.010904 | IL | Primary |
Addresses
Primary practice location
2121 W Division St
Chicago, IL 60622-2948
Mailing address
2121 W Division St
Chicago, IL 60622-2948
Phone (773) 697-7370
Other names 1
- Ms. Cassandra Anne Weinfurter
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046.010904 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Village Eye Care LTD | Optometrist | Current | Accepting new patients |
| D J Dawson MD Incorporated | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Chicago, IL
- NPI 1477601664
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dba Ticho Eye Associates
- Ophthalmology Physician
- Chicago Ridge, IL
- NPI 1043794506
-
- Ophthalmology Physician
- Munster, IN
- NPI 1558644476
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437436800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1581897600000",
"number": "1093190019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2121 W DIVISION ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606222948",
"telephone_number": "773-697-7370"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2121 W DIVISION ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606222948",
"telephone_number": "773-697-7370"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KOUTNIK",
"first_name": "CASSANDRA",
"middle_name": "ANNE",
"name_prefix": "Mrs.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-07-21",
"last_updated": "2020-02-17",
"certification_date": "2020-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046.010904",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "CASSANDRA",
"last_name": "WEINFURTER",
"middle_name": "ANNE",
"prefix": "MS.",
"credential": "O.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2020; 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.