Organization Active NPI

Eric Tseng O.D., Prof. Corp.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1164664280
Registry record updated Apr 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010071 Issued in IL
Legal business name
ERIC TSENG O.D., PROF. CORP.
Practice address
9928 S Western Ave
Chicago, IL 60643-1831
Phone
(773) 303-8279
Fax
(773) 681-7119
NPI assigned
Apr 3, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2026

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

Authorized official

Name
Dr. Eric Tseng, O.D.NPI 1629233580
Title
President
Phone
(773) 303-8279

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 152W00000X 046010071 IL Primary

Addresses

Primary practice location

9928 S Western Ave
Chicago, IL 60643-1831

Mailing address

9928 S Western Ave
Chicago, IL 60643-1831
Phone (773) 303-8279

Other identifiers 3

IdentifierTypeStateIssuer
046010071MedicaidIL
1629233580MedicaidIL
IL2815OtherILPTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100109000359 IL Part B Supplier - Clinic/Group Practice 0143361303 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1238716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776902400000",
    "number": "1164664280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9928 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431831",
            "telephone_number": "773-303-8279",
            "fax_number": "773-681-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9928 S WESTERN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606431831",
            "telephone_number": "773-303-8279",
            "fax_number": "773-681-7119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIC TSENG O.D., PROF. CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-03",
        "last_updated": "2026-04-23",
        "certification_date": "2026-04-23",
        "status": "A",
        "authorized_official_last_name": "TSENG",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-303-8279",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046010071",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1629233580",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "IL2815",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2026; 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.