The Optometrists, P.C.

Primary specialty

OptometristTaxonomy code 152W00000X

License

060-008788 Issued in IL

Legal business name

THE OPTOMETRISTS, P.C.

Practice address

1544 Shermer Rd
Northbrook, IL 60062-5347

Phone

(847) 498-4770

Fax

(847) 498-6909

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Ronald J Henderson, O.D.NPI 1063529428

Title

Owner/Operator

Phone

(847) 498-4770

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Optometrists of the North Shore Doing business as

Medicare fee-for-service enrollment

Enrolled in IL2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Tax ID family

Optometrists of the North Shore2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• The Optometrists, P.C.

  • Optometrist
  • Lake Forest, IL
  • NPI 1205912466
  NPD tax ID

Locations

Practitioners 5

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

• Ronald J Henderson, O.D.

  • Optometrist
  • Northbrook, IL
  • NPI 1063529428
  Medicare reassignment Care Compare group NPD Authorized official
• Russell M Brody, O.D.

  • Optometrist
  • Northbrook, IL
  • NPI 1982711354
  Medicare reassignment Care Compare group NPD
• Tricia Valters Danz, O.D.

  • Optometrist
  • Lake Forest, IL
  • NPI 1316917149
  Medicare reassignment Care Compare group NPD
• Rahnuma J Saiyed, O.D.

  • Optometrist
  • Chicago, IL
  • NPI 1649532706
  Medicare reassignment Care Compare group NPD
• Alice White, LCSW

  • Clinical Social Worker
  • Northbrook, IL
  • NPI 1225112675
  NPD (past)

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661472000000",
    "number": "1114008455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1544 SHERMER RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600625347",
            "telephone_number": "847-498-4770",
            "fax_number": "847-498-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1544 SHERMER RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600625347",
            "telephone_number": "847-498-4770",
            "fax_number": "847-498-6909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE OPTOMETRISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2022-08-26",
        "certification_date": "2022-05-09",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "847-498-4770",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "060-008788",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "01636744",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Optometrists of the North Shore",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Optometrists of the North Shore",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.

Verify at the official NPI Registry.