Organization Active NPI

James a Vitale O.D., P.C.

  • Optometrist
  • Addison, IL
National Provider Identifier
1184978553
Registry record updated Nov 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JAMES A VITALE O.D., P.C.
Practice address
1600 W Lake St
Suite 106
Addison, IL 60101-1822
Phone
(630) 773-9410
NPI assigned
Nov 6, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2012

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

Authorized official

Name
Denise Vitale
Title
Office Manager
Phone
(630) 251-8438

Specialties & licenses 1

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

Addresses

Primary practice location

1600 W Lake St
Suite 106
Addison, IL 60101-1822

Mailing address

1600 W Lake St
Suite 106
Addison, IL 60101-1822
Phone (630) 773-9410

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121108000533 IL Part B Supplier - Clinic/Group Practice 9436352010 Receives reassigned benefits from 1 practitioner
Practice locations: Addison, IL

National Provider Directory

National Provider Directory

Locations

1600 W Lake St
Ste 106
Addison, IL 60101
Phone (630) 773-9410

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": "1352160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352160000000",
    "number": "1184978553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W LAKE ST",
            "address_2": "SUITE 106",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601011822",
            "telephone_number": "630-773-9410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W LAKE ST",
            "address_2": "SUITE 106",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601011822",
            "telephone_number": "630-773-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES A VITALE O.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-06",
        "last_updated": "2012-11-06",
        "status": "A",
        "authorized_official_last_name": "VITALE",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "630-251-8438"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.