Elizabeth Grace Dziuba, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046008878 Issued in IL

Practice address

373 N Wood Dale Rd
Wood Dale, IL 60191-1531

Phone

(630) 422-1413

Fax

(630) 422-1454

NPI assigned

Jun 16, 2006

Last updated

Jul 29, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Eizabeth Grace Dziuba Bentancur Other name

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Look Sharp Eye Care Specialists LTD

  • Optometrist
  • Wood Dale, IL
  • NPI 1053448118
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438128000000",
    "number": "1114961208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "373 N WOOD DALE RD",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601911531",
            "telephone_number": "630-422-1413",
            "fax_number": "630-422-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "373 N WOOD DALE RD",
            "city": "WOOD DALE",
            "state": "IL",
            "postal_code": "601911531",
            "telephone_number": "630-422-1413",
            "fax_number": "630-422-1454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIUBA",
        "first_name": "ELIZABETH",
        "middle_name": "GRACE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2015-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008878",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EIZABETH",
            "last_name": "DZIUBA BENTANCUR",
            "middle_name": "GRACE",
            "credential": "O.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Christie Drzewiecki, D.C.
• Michael Nathan Drzewiecki, DC
• Duramedix Supply LLC
• Elizabeth C Edeh, MOT, OTR/R
• Alison Rae Eier, M.S.
• Alfred Julian Feinblatt, D.C.
• Erin Ann Ferguson
• First Class Caregivers

• Optometrist in Wood Dale, IL
• Providers in Wood Dale, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.