Emily R Konczal, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046010175 Issued in IL

Practice address

9500 S Western Ave Ste G3A
Evergreen Park, IL 60805-2868

Phone

(708) 425-5285

NPI assigned

Dec 9, 2008

Sex

Female

Sole proprietor

No

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, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christina J. Levi O D P C.Group PAC ID 9436210762, 63 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Christina J. Levi O D P C

  • Optometrist
  • Edwardsville, IL
  • NPI 1477703411
  Medicare reassignment Care Compare group
• Luxottica of America Inc.

  • Point of Service
  • Mason, OH
  • NPI 1831244953

  IL

  Medicare reassignment
• Luxottica of America Inc

  • Eyewear Supplier
  • Kansas City, MO
  • NPI 1497412522
  NPD (past)

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

{
    "created_epoch": "1228780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228780800000",
    "number": "1184869927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9500 S WESTERN AVE STE G3A",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052868",
            "telephone_number": "708-425-5285"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9500 S WESTERN AVE STE G3A",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052868",
            "telephone_number": "708-425-5285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KONCZAL",
        "first_name": "EMILY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-12-09",
        "last_updated": "2008-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Knightly
• Alyssa Nicole Knueven, PA-C
• Kathleen Ann Kociak, RN, MS, GNP-BC
• Mark Anthony Koludrovic, DDS
• Thomas Anthony Koludrovic, DDS
• Goutham Kondapi
• Elizabeth R Konieczny
• Anne Koronkiewicz, DO
• Bahij Kreidieh
• Christopher Michael Krippinger, PA-C

• Optometrist in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2008; 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.