Individual provider Active NPI

Dorota Czaicka, O.D.

  • Optometrist
  • Glenview, IL
National Provider Identifier
1164572244
Registry record updated Oct 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009430 Issued in IL
Practice address
2305 Willow Rd
Glenview, IL 60025-7637
Phone
(847) 832-9690
Fax
(847) 832-9691
NPI assigned
Jan 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 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 046009430 IL Primary

Addresses

Primary practice location

2305 Willow Rd
Glenview, IL 60025-7637

Mailing address

2305 Willow Rd
Glenview, IL 60025-7637
Phone (847) 832-9690

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
I20031212000540 IL Practitioner - Optometry 3476450065 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009430ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc. Optometrist CurrentSince Aug 1, 2017 Accepting new patients
Visionworks, Inc CurrentSince Aug 1, 2017 Accepting new patients
Ziva Optical II, LTD. Optometrist PastSince Oct 1, 2014 Accepting new patients
Ziva Optical, LTD. Optometrist PastSince Dec 6, 2015 Accepting new patients

Locations

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
San Antonio, TX 78205
Phone (210) 524-6982

Organizations & group practices 4

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": "1168473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412726400000",
    "number": "1164572244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2305 WILLOW RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600257637",
            "telephone_number": "847-832-9690",
            "fax_number": "847-832-9691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2305 WILLOW RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600257637",
            "telephone_number": "847-832-9690",
            "fax_number": "847-832-9691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZAICKA",
        "first_name": "DOROTA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-11",
        "last_updated": "2014-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009430",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glenview, IL

Sources for this page

Verify at the official NPI Registry.