Active NPI
Laurie Lynn Collett, OD
- Optometrist
- Olympia Fields, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046008862
- Practice address
- 3406 Vollmer Rd
Olympia Fields, IL 60461-1018 - Phone
- (708) 748-6516
- Fax
- (708) 748-6079
- NPI assigned
- Oct 3, 2005
- Last updated
- Apr 25, 2014
- 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 | 046008862 | IL | Primary |
Addresses
Primary practice location
3406 Vollmer Rd
Olympia Fields, IL 60461-1018
Mailing address
3406 Vollmer Rd
Olympia Fields, IL 60461-1018
Phone (708) 748-6516
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
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
170 S Locust St
Manteno, IL 60950-1518
Phone (815) 468-2525
5408 N Clark St
Chicago, IL 60640-1210
Phone (773) 275-2020
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046008862 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Myeyedr Optometry of Illinois, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Illinois, LLC | Optometrist | Current | Accepting new patients |
| Myeyedr Optometry of Illinois, LLC | Optometrist | Current | Accepting new patients |
| Metropolitan Eyecare Beecher | Optometrist | Past | Accepting new patients |
| Myeyedr Optometry of Illinois, LLC | Optometrist | Past | Accepting new patients |
| Fisher-Swale-Nicholson Eye Center SC | Optometrist | Past | Accepting new patients |
| Metropolitan Eyecare | Optometrist | Past | Accepting new patients |
Locations
5408 N Clark St
Chicago, IL 60640
Phone (773) 275-2020
170 S Locust St
Manteno, IL 60950
Phone (815) 468-2525
4852 211th St
Matteson, IL 60443
Phone (708) 747-4800
8614 Westwood Center Dr
Fl 9
Vienna, VA 22182
Organizations & group practices 8
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
- Olympia Fields, IL
- NPI 1750400503
-
- Optometrist
- Matteson, IL
- NPI 1780703587
-
- Optometrist
- Beecher, IL
- NPI 1033345798
-
- Optometrist
- Chicago, IL
- NPI 1154297752
-
- Ophthalmology Physician
- Bourbonnais, IL
- NPI 1639277940
Optometrist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1128297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1398384000000",
"number": "1093702300",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3406 VOLLMER RD",
"city": "OLYMPIA FIELDS",
"state": "IL",
"postal_code": "604611018",
"telephone_number": "708-748-6516",
"fax_number": "708-748-6079"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3406 VOLLMER RD",
"city": "OLYMPIA FIELDS",
"state": "IL",
"postal_code": "604611018",
"telephone_number": "708-748-6516",
"fax_number": "708-748-6079"
}
],
"practiceLocations": [],
"basic": {
"last_name": "COLLETT",
"first_name": "LAURIE",
"middle_name": "LYNN",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-10-03",
"last_updated": "2014-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046008862",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Olympia Fields, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2014; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.