Individual provider Active NPI

Katie Kwan, OD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1124672142
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011337 Issued in IL
Practice address
2700 N Narragansett Ave # F4-F5
Chicago, IL 60639-1083
Phone
(218) 731-4120
NPI assigned
Jul 29, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046011337 IL Primary

Addresses

Primary practice location

2700 N Narragansett Ave # F4-F5
Chicago, IL 60639-1083

Mailing address

801 S Financial PL Apt 2804
Chicago, IL 60605-1791

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, TN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20210426002186 IL Practitioner - Optometry 4284042532 Reassigns benefits to 2 organizations
I20231211000643 TN Practitioner - Optometry 4284042532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Board of Trustees of the University of IllinoisGroup PAC ID 3072422716, 1,134 clinicians

Practice addresses (Care Compare)

1009 S Wood St
Chicago, IL 60612-3747
Phone (312) 355-4300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Southern College of Optometry Optometrist CurrentSince Oct 30, 2023 Accepting new patients
Loyola University Medical Center Current Accepting new patients
Tennenbaum and Anstadt, LTD CurrentSince Apr 19, 2021 Accepting new patients
The Board of Trustees of the University of Illinois Current Accepting new patients
Tennenbaum and Anstadt, LTD CurrentSince Apr 19, 2021 Accepting new patients
The Board of Trustees of the University of Illinois CurrentSince Aug 1, 2024 Accepting new patients
The Board of Trustees of the University of Illinois Optometrist CurrentSince Aug 1, 2024 Accepting new patients

Locations

2525 S Michigan Ave
Chicago, IL 60616
Phone (312) 355-1153

7732 Solution Ctr
Chicago, IL 60677
Phone (312) 355-6290

675 W North Ave
Ste 107
Melrose Park, IL 60160
Phone (708) 450-4510

1350 Concourse Ave
Ste 264
Memphis, TN 38104
Phone (901) 252-3670

1245 Madison Ave
Memphis, TN 38104
Phone (901) 722-3250

Interoperability endpoints

  • Direct secure messaging: kkwan142650@direct.luhs.org
  • Direct secure messaging: kkwan170971@uihealth.direct-ci.com

Organizations & group practices 7

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": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743379200000",
    "number": "1124672142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 S FINANCIAL PL APT 2804",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 N NARRAGANSETT AVE # F4-F5",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606391083",
            "telephone_number": "218-731-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWAN",
        "first_name": "KATIE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-29",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.