Individual provider Active NPI

Breeze Evelyn Bellen, O.D.

  • Optometrist
  • Park Ridge, IL
National Provider Identifier
1124011788
Registry record updated Jun 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009782 Issued in IL
Practice address
350 S Northwest Hwy Ste 104
Park Ridge, IL 60068-4262
Phone
(847) 823-8283
NPI assigned
Aug 29, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009782 IL Primary

Addresses

Primary practice location

350 S Northwest Hwy Ste 104
Park Ridge, IL 60068-4262

Mailing address

350 S Northwest Hwy Ste 104
Park Ridge, IL 60068-4262
Phone (847) 823-8283

Other names 1

  • Dr. Breeze Evelyn Feiler Former name

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
I20060116000398 IL Practitioner - Optometry 5395769574 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
Park Ridge Vision LLCGroup PAC ID 1052646437, 4 clinicians

Practice addresses (Care Compare)

350 S Northwest Hwy
Suite 104
Park Ridge, IL 60068-4262
Phone (847) 823-8283

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Park Ridge Vision LLC Optometrist CurrentSince Feb 23, 2022 Accepting new patients
B.E.F. Enterprises, Inc. Optometrist PastSince Aug 17, 2009 Accepting new patients
Contact Lenses Unlimited Optometrist Past Accepting new patients
Emma Loyfman Odpc Optometrist Past Accepting new patients

Locations

350 S Northwest Hwy
Park Ridge, IL 60068
Phone (847) 470-1500

350 S Northwest Hwy
Ste 104
Park Ridge, IL 60068
Phone (847) 518-5353

Organizations & group practices 4

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": "1125273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1124011788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 S NORTHWEST HWY STE 104",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684262",
            "telephone_number": "847-823-8283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 S NORTHWEST HWY STE 104",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684262",
            "telephone_number": "847-823-8283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELLEN",
        "first_name": "BREEZE",
        "middle_name": "EVELYN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-29",
        "last_updated": "2024-06-05",
        "certification_date": "2024-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BREEZE",
            "last_name": "FEILER",
            "middle_name": "EVELYN",
            "prefix": "DR.",
            "credential": "O.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.