Individual provider Active NPI

Stephanie Lynn Lyons, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1104056191
Registry record updated Oct 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010219 Issued in IL
Practice address
3250 N. Lincoln Ave.
Chicago, IL 60657-7757
Phone
(773) 935-2020
NPI assigned
Jul 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010219 IL Primary

Addresses

Primary practice location

3250 N. Lincoln Ave.
Chicago, IL 60657-7757

Mailing address

225 N Michigan Ave
Lenscrafters
Chicago, IL 60601-7757
Phone (312) 819-0205

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
I20091202000634 IL Practitioner - Optometry 2668511742 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lyons Family Eyecare PCGroup PAC ID 3577752690, 3 clinicians

Practice addresses (Care Compare)

3250 N Lincoln Ave
Chicago, IL 60657-1117
Phone (773) 935-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046010219ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lyons Family Eyecare PC Optometrist CurrentSince Sep 1, 2010 Accepting new patients

Organizations & group practices 1

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": "1248307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1287360000000",
    "number": "1104056191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 N MICHIGAN AVE",
            "address_2": "LENSCRAFTERS",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606017757",
            "telephone_number": "312-819-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3250 N. LINCOLN AVE.",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577757",
            "telephone_number": "773-935-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYONS",
        "first_name": "STEPHANIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-23",
        "last_updated": "2010-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.