Advanced Eyecare Clinic, Inc

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

046009272 Issued in IL

Legal business name

ADVANCED EYECARE CLINIC, INC

Practice address

45 W Acorn LN
Lake in the Hills, IL 60156-4804

Phone

(847) 854-0202

NPI assigned

Sep 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. David Rocks, ODNPI 1023016151

Title

President

Phone

(847) 854-0202

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David Rocks, OD

  • Optometrist
  • Lake in the Hills, IL
  • NPI 1023016151
  Medicare reassignment Care Compare group NPD Authorized official
• Erica Kosiba, O.D.

  • Optometrist
  • Lake in the Hills, IL
  • NPI 1649567074
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1104012772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 W ACORN LN",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601564804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W ACORN LN",
            "city": "LAKE IN THE HILLS",
            "state": "IL",
            "postal_code": "601564804",
            "telephone_number": "847-854-0202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED EYECARE CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "ROCKS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-854-0202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IL",
            "license": "046009272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD PTAN",
            "identifier": "DG7196",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chaitra Rao Aithal, DDS
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• Corneal and Contact Management Optometrist in Lake in the Hills, IL
• Providers in Lake in the Hills, IL by specialty
• Corneal and Contact Management Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.