Individual provider Active NPI

Maria Pappas, OD

  • Optometrist
  • Warrenville, IL
National Provider Identifier
1164244000
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.011932 Issued in IL
Practice address
28201 Diehl Rd
Warrenville, IL 60555-3934
Phone
(630) 836-8830
NPI assigned
Oct 31, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.011932 IL Primary

Addresses

Primary practice location

28201 Diehl Rd
Warrenville, IL 60555-3934

Mailing address

28201 Diehl Rd
Warrenville, IL 60555-3934
Phone (630) 836-8830

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
046.011932ILMDOptometrist

NPI Registry JSON

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

{
    "created_epoch": "1730332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1164244000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28201 DIEHL RD",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553934",
            "telephone_number": "630-836-8830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28201 DIEHL RD",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605553934",
            "telephone_number": "630-836-8830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPPAS",
        "first_name": "MARIA",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-10-31",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warrenville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.