Individual provider Active NPI

Victoria Whitman

  • Optometrist
  • Chicago, IL
National Provider Identifier
1134538903
Registry record updated Aug 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010842 Issued in IL
Practice address
1101 S Canal St
Chicago, IL 60607-4901
Phone
(312) 588-0159
NPI assigned
Aug 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010842 IL Primary

Addresses

Primary practice location

1101 S Canal St
Chicago, IL 60607-4901

Mailing address

555 W Madison St
Chicago, IL 60661-2514
Phone (312) 833-1871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20160816000402 MN Practitioner - Optometry 5799906517 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Eye Doctors Office PAGroup PAC ID 5294720777, 2 clinicians

Practice addresses (Care Compare)

747 Lake St E
Wayzata, MN 55391-1712
Phone (952) 404-2020

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery12

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Eye Doctors Office, PA Optometrist Current Accepting new patients
The Eye Doctors Office, PA Optometrist CurrentSince Nov 19, 2017 Accepting new patients

Locations

747 Lake St E
Wayzata, MN 55391
Phone (952) 404-2020

Organizations & group practices 2

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": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407283200000",
    "number": "1134538903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606612514",
            "telephone_number": "312-833-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 S CANAL ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606074901",
            "telephone_number": "312-588-0159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITMAN",
        "first_name": "VICTORIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-06",
        "last_updated": "2014-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.