Angela C Pak Oh, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046010659 Issued in IL

Practice address

730 N Milwaukee Ave
Libertyville, IL 60048-1914

Phone

(847) 362-9900

NPI assigned

Jun 11, 2013

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 names 1

• Angela C Pak 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, 2013

Medicare assignment

May accept Medicare assignment

Group practices

730 North Optometry PCGroup PAC ID 7517858657, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• 730 North Optometry PC

  • Optometrist
  • Libertyville, IL
  • NPI 1821435660
  Medicare reassignment Care Compare group Authorized official
• Brain-Eye Evolution at 730 North

  • Vision Therapy Optometrist
  • Libertyville, IL
  • NPI 1851741714
  NPD (past)

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1134567225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 N MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481914",
            "telephone_number": "847-362-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 N MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481914",
            "telephone_number": "847-362-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAK OH",
        "first_name": "ANGELA",
        "middle_name": "C",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-11",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANGELA",
            "last_name": "PAK",
            "middle_name": "C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Karen L. Otto, APRN
• Outperforming Physical Therapy & Performance
• Frances J Pacheco, PSY.D.
• Vincenzo Padovano, MD
• Cheryl A Pahl, APRN
• Stacey Lyn Durnbaugh Palmer, MPT
• Mark Palmero
• Michael Eugene Palmieri, PT
• Panacea Dental P.C.
• Jennifer Lynn Panicko, R.D

• Optometrist in Libertyville, IL
• Providers in Libertyville, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.