Active NPI
Chad Michael Parks, O.D.
- Optometrist
- Champaign, IL
National Provider Identifier
1184039539
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046010792
- Practice address
- 2000 N Neil St
Champaign, IL 61820-7808 - Phone
- (815) 821-3810
- NPI assigned
- Jun 24, 2014
- Last updated
- Jul 21, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046010792 | IL | Primary |
Addresses
Primary practice location
2000 N Neil St
Champaign, IL 61820-7808
Mailing address
2000 N Neil St
Champaign, IL 61820-7808
Phone (815) 821-3810
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2014
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
8318 Blackwolf Dr
Madison, WI 53717-2620
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1403568000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1184039539",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 N NEIL ST",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618207808",
"telephone_number": "815-821-3810"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 N NEIL ST",
"city": "CHAMPAIGN",
"state": "IL",
"postal_code": "618207808",
"telephone_number": "815-821-3810"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARKS",
"first_name": "CHAD",
"middle_name": "MICHAEL",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-06-24",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046010792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Champaign, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.