John Ichishita, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046.010675 Issued in IL

Practice address

730 N Milwaukee Ave
Libertyville, IL 60048-1914

Phone

(847) 362-9900

Fax

(847) 362-9936

NPI assigned

Jul 30, 2013

Last updated

Apr 25, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2013

Medicare assignment

May accept Medicare assignment

Group practices

Accuvision Center IncGroup PAC ID 3870567936, 4 clinicians

730 North Optometry PCGroup PAC ID 7517858657, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• 730 North Optometry PC

  dba 730 north optometry

  • Optometrist
  • Libertyville, IL
  • NPI 1821435660
  Medicare reassignment Care Compare group NPD
• Accu-Vision Center Inc.

  dba Accuvision

  • Optometrist
  • Lindenhurst, IL
  • NPI 1477676914
  Medicare reassignment Care Compare group NPD
• Accu-Vision Center Inc.

  dba Accuvision

  • Optometrist
  • Round Lake Beach, IL
  • NPI 1114167541
  NPD (past)
• Accu-Vision Center Inc.

  dba Accuvision

  • Optometrist
  • Gurnee, IL
  • NPI 1528406279
  NPD (past)
• Brain-Eye Evolution at 730 North

  • Vision Therapy Optometrist
  • Libertyville, IL
  • NPI 1851741714
  NPD (past)

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

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745539200000",
    "number": "1164854386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "730 N MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481914",
            "telephone_number": "847-362-9900",
            "fax_number": "847-362-9936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "730 N MILWAUKEE AVE",
            "city": "LIBERTYVILLE",
            "state": "IL",
            "postal_code": "600481914",
            "telephone_number": "847-362-9900",
            "fax_number": "847-362-9936"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "824 N Il Route 83",
            "address_purpose": "LOCATION",
            "city": "Mundelein",
            "state": "IL",
            "postal_code": "600609159",
            "country_code": "US",
            "telephone_number": "847-362-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ICHISHITA",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-07-30",
        "last_updated": "2025-04-25",
        "certification_date": "2025-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.010675",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.