Individual provider Active NPI

Anita V Patel, OD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1164526562
Registry record updated Oct 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010621 Issued in IL
Practice address
2158 N Damen Ave
Chicago, IL 60647-9597
Phone
(773) 782-1660
NPI assigned
Sep 7, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 2236 CO
Optometrist 152W00000X 046010621 IL Primary

Addresses

Primary practice location

2158 N Damen Ave
Chicago, IL 60647-9597

Mailing address

2158 N Damen Ave
Chicago, IL 60647-9597
Phone (720) 837-8084

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20171012002498 IL Practitioner - Optometry 6406876739 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Exemplary Eyecare PLLCGroup PAC ID 6507207644, 2 clinicians

Practice addresses (Care Compare)

2158 N Damen Ave
Chicago, IL 60647-9597
Phone (773) 782-1660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046010621ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Double a Vision PLLC Optometrist Current Accepting new patients
Visionworks, Inc CurrentSince Aug 19, 2017 Accepting new patients
Exemplary Eyecare PLLC Optometrist CurrentSince Feb 18, 2024 Accepting new patients
Matthew W. Gifford, O.D., P.C Optometrist CurrentSince Oct 23, 2022 Accepting new patients
Visionworks, Inc. Optometrist CurrentSince Aug 19, 2017 Accepting new patients

Locations

4313 S Pulaski Rd
Chicago, IL 60632
Phone (773) 847-1911

1101 S Canal St
Ste 108
Chicago, IL 60607
Phone (312) 558-0159

239 Golf Mill Ctr
Ste 255
Niles, IL 60714
Phone (847) 297-2286

2422 US Highway 34
Oswego, IL 60543
Phone (630) 551-4133

175 E Houston St
Fl 5
San Antonio, TX 78205
Phone (210) 524-6922

Organizations & group practices 5

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": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666310400000",
    "number": "1164526562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2158 N DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606479597",
            "telephone_number": "720-837-8084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2158 N DAMEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606479597",
            "telephone_number": "773-782-1660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "ANITA",
        "middle_name": "V",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-07",
        "last_updated": "2022-10-21",
        "certification_date": "2022-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CO",
            "license": "2236",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.