NPIMap

Organization Active NPI

Eye Boutique, LLC

  • Optometrist
  • New Berlin, WI
National Provider Identifier
1114144276
Registry record updated Aug 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE BOUTIQUE, LLC
Practice address
16800 W Cleveland Ave
New Berlin, WI 53151-3533
Phone
(262) 432-2005
Fax
(262) 432-2006
NPI assigned
Apr 19, 2007
Organization subpart
Yes
Parent organization
LUXOTTICA OF AMERICA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 4, 2026

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

Authorized official

Name
Mr. Darren Thomas Horndasch
Title
President
Phone
(262) 923-7240

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

16800 W Cleveland Ave
New Berlin, WI 53151-3533

Mailing address

16800 W Cleveland Ave
New Berlin, WI 53151-3533
Phone (262) 432-2005

Other practice location 1

5005 Northwest Hwy
Crystal Lake, IL 60014-7324
Phone (815) 479-0177

Other practice location 2

2509 County Line Rd
Algonquin, IL 60102-2566
Phone (847) 658-7661

Other practice location 3

1273 S Naper Blvd
Naperville, IL 60540-8300
Phone (630) 369-8098

Other practice location 4

2239 W Jefferson St
Joliet, IL 60435-6303
Phone (815) 729-3752

Other practice location 5

1839 W Irving Park Rd
Schaumburg, IL 60193-3509
Phone (847) 891-9096

Other practice location 6

1622 Commons Dr
Geneva, IL 60134-2531
Phone (262) 923-7674

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20090304000089 IL Part B Supplier - Clinic/Group Practice 7012073851 Receives reassigned benefits from 6 practitioners
8 other NPIs on this enrollment
Practice locations: Schaumburg, IL; Naperville, IL; Joliet, IL; Geneva, IL; Crystal Lake, IL; Algonquin, IL
O20100930018326 IL DME Supplier - Physician - Optometrist 7012073851 Practice locations: Schaumburg, IL

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Jacobsen OD

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1273 S Naper Blvd
Naperville, IL 60540
Phone (630) 369-8098

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785801600000",
    "number": "1114144276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16800 W CLEVELAND AVE",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531513533",
            "telephone_number": "262-432-2005",
            "fax_number": "262-432-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16800 W CLEVELAND AVE",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531513533",
            "telephone_number": "262-432-2005",
            "fax_number": "262-432-2006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5005 Northwest Hwy",
            "address_purpose": "LOCATION",
            "city": "Crystal Lake",
            "state": "IL",
            "postal_code": "600147324",
            "country_code": "US",
            "telephone_number": "815-479-0177",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2509 County Line Rd",
            "address_purpose": "LOCATION",
            "city": "Algonquin",
            "state": "IL",
            "postal_code": "601022566",
            "country_code": "US",
            "telephone_number": "847-658-7661",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1273 S Naper Blvd",
            "address_purpose": "LOCATION",
            "city": "Naperville",
            "state": "IL",
            "postal_code": "605408300",
            "country_code": "US",
            "telephone_number": "630-369-8098",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2239 W Jefferson St",
            "address_purpose": "LOCATION",
            "city": "Joliet",
            "state": "IL",
            "postal_code": "604356303",
            "country_code": "US",
            "telephone_number": "815-729-3752",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1839 W Irving Park Rd",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601933509",
            "country_code": "US",
            "telephone_number": "847-891-9096",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1622 Commons Dr",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "IL",
            "postal_code": "601342531",
            "country_code": "US",
            "telephone_number": "262-923-7674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EYE BOUTIQUE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LUXOTTICA OF AMERICA INC",
        "enumeration_date": "2007-04-19",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A",
        "authorized_official_last_name": "HORNDASCH",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-923-7240",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Berlin, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; 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.