Individual provider Active NPI

John Anthony Loesch, OD

  • Optometrist
  • Villa Park, IL
National Provider Identifier
1124103916
Registry record updated Mar 11, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-008334 Issued in IL
Practice address
25 S Villa Ave
Villa Park, IL 60181-2650
Phone
(630) 832-6783
NPI assigned
Oct 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-008334 IL Primary

Addresses

Primary practice location

25 S Villa Ave
Villa Park, IL 60181-2650

Mailing address

215 S Villa Ave
3
Villa Park, IL 60181-2687
Phone (630) 833-6214

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
I20070713000789 IL Practitioner - Optometry 2860592250 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-008334ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc CurrentSince Jan 19, 2013 Accepting new patients
Visionworks, Inc. Optometrist CurrentSince Jan 19, 2013 Accepting new patients
Dr. James M Saul & Associates PC Optometrist PastSince Jan 1, 1990 Accepting new patients
Precision Vision Eyecare PC Optometrist PastSince Feb 18, 2024 Accepting new patients

Locations

239 Golf Mill Ctr
Ste 255
Niles, IL 60714
Phone (847) 297-2286

2422 US Highway 34
Oswego, IL 60543
Phone (630) 551-4133

19100 Ridgewood Pkwy
Bldg 1
San Antonio, TX 78259
Phone (726) 444-4069

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268265600000",
    "number": "1124103916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 S VILLA AVE",
            "address_2": "3",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601812687",
            "telephone_number": "630-833-6214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 S VILLA AVE",
            "city": "VILLA PARK",
            "state": "IL",
            "postal_code": "601812650",
            "telephone_number": "630-832-6783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOESCH",
        "first_name": "JOHN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-27",
        "last_updated": "2010-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villa Park, IL

Sources for this page

Verify at the official NPI Registry.