Individual provider Active NPI

Viktoriya Marmur, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1114023785
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
2734 N Milwaukee Ave
Chicago, IL 60647-1362
Phone
(773) 862-5000
Fax
(773) 862-5059
NPI assigned
Sep 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X IL Primary

Addresses

Primary practice location

2734 N Milwaukee Ave
Chicago, IL 60647-1362

Mailing address

70 W Burton PL Apt 1206
Chicago, IL 60610-1468
Phone (224) 595-0595

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
I20210519002759 IL Practitioner - Optometry 1456750637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prism Eye Care, Inc.Group PAC ID 1557469343, 2 clinicians

Practice addresses (Care Compare)

7311 N Melvina Ave
Niles, IL 60714-3905
Phone (847) 972-3012

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009800ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Prism Eye Care, Inc. Optometrist CurrentSince Apr 1, 2021 Accepting new patients

Locations

7311 N Melvina Ave
Niles, IL 60714
Phone (847) 972-3002

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": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1114023785",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 W BURTON PL APT 1206",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606101468",
            "telephone_number": "224-595-0595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2734 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606471362",
            "telephone_number": "773-862-5000",
            "fax_number": "773-862-5059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARMUR",
        "first_name": "VIKTORIYA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.