Michael S Russell, OD, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

MICHAEL S RUSSELL, OD, LLC

Practice address

1112 S Washington St Ste 214
Naperville, IL 60540-7964

Phone

(630) 355-6878

Fax

(630) 355-0043

NPI assigned

Dec 13, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Michael S Russell, ODNPI 1619351715

Title

Owner, Optometrist

Phone

(630) 355-6878

Specialties & licenses 1

Addresses

Other names 1

• Professional Eyecare Center Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michael Steven Russell, O.D.

  • Optometrist
  • Naperville, IL
  • NPI 1619351715
  Medicare reassignment NPD Authorized official
• Kimberly M Garvey, O.D.

  • Optometrist
  • Hickory Hills, IL
  • NPI 1831571140
  Medicare reassignment NPD
• Dennis W Kirscher, O.D.

  • Optometrist
  • Homer Glen, IL
  • NPI 1083604177
  Medicare reassignment NPD
• Richard Frank Butz, O.D.

  • Optometrist
  • Naperville, IL
  • NPI 1710076245
  NPD
• Katherine Bridget Lynch, O.D.

  • Optometrist
  • Chicago, IL
  • NPI 1427316918
  NPD

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

{
    "created_epoch": "1607817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607817600000",
    "number": "1154917375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1112 S WASHINGTON ST STE 214",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605407964",
            "telephone_number": "630-355-6878",
            "fax_number": "630-355-0043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1112 S WASHINGTON ST STE 214",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605407964",
            "telephone_number": "630-355-6878",
            "fax_number": "630-355-0043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL S RUSSELL, OD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-13",
        "last_updated": "2020-12-13",
        "certification_date": "2020-12-13",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER, OPTOMETRIST",
        "authorized_official_telephone_number": "630-355-6878",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Professional Eyecare Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Feingold, M.D. and Associates, L.L.C.
• Michael J Caron MD SC
• Michael J Karakourtis DDS LTD.
• Michael J. Reicherts, MD SC
• Michael Reese Physician Group
• Michael Wagner, S.C.
• Christine Michaels, DDS MDS
• Daniel Michaels, LPC
• Angela Marie Michalak, MA, LCPC
• Anastasios Michalopulos, M.S., CCC-SLP/L

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.