Individual provider Active NPI

Steven J Lichtenstein, M.D.

  • Ophthalmology Physician
  • Peoria, IL
National Provider Identifier
1093702649
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Practice address
8921 N. Wood Sage Rd.
Peoria, IL 61615-7822
Phone
(309) 243-2400
Fax
(309) 243-7918
NPI assigned
Sep 29, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X IL Primary

Addresses

Primary practice location

8921 N. Wood Sage Rd.
Peoria, IL 61615-7822

Mailing address

8921 N. Wood Sage Rd.
Peoria, IL 61615-7822
Phone (309) 243-2400

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050920001325 IL Practitioner - Ophthalmology 0941234843 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
University of Louisville School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Illini Dr
Peoria, IL 61605-2576
Phone (309) 671-8484

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036114063ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Board of Trustees of the University of Illinois CurrentSince Aug 16, 2020 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Multi-Specialty Group CurrentSince Jun 1, 2016 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Aug 16, 2020 Accepting new patients

Locations

7694 Solutions Ctr
Chicago, IL 60677

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

4927 N Glen Park Place Rd
Peoria, IL 61614
Phone (309) 308-3500

1 Illini Dr
Peoria, IL 61605
Phone (309) 671-3000

Organizations & group practices 5

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": "1127952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1093702649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8921 N. WOOD SAGE RD.",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157822",
            "telephone_number": "309-243-2400",
            "fax_number": "309-243-7918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8921 N. WOOD SAGE RD.",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616157822",
            "telephone_number": "309-243-2400",
            "fax_number": "309-243-7918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTENSTEIN",
        "first_name": "STEVEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-29",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

Verify at the official NPI Registry.