Individual provider Active NPI

Laurie Lynn Collett, OD

  • Optometrist
  • Olympia Fields, IL
National Provider Identifier
1093702300
Registry record updated Apr 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046008862 Issued in IL
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, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100928000185 IL Practitioner - Optometry 4688790660 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
046008862ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Illinois, LLC Optometrist CurrentSince Jun 15, 2025 Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist CurrentSince Jun 15, 2025 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 PastSince Feb 1, 2010 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.

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

Verify at the official NPI Registry.