Individual provider Active NPI

Aleksandra Susol, OD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1194393645
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.011508 Issued in IL
Practice address
942 W Madison St
Chicago, IL 60607-2601
Phone
(312) 829-6800
NPI assigned
Jun 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.011508 IL Primary

Addresses

Primary practice location

942 W Madison St
Chicago, IL 60607-2601

Mailing address

942 W Madison St
Chicago, IL 60607-2601
Phone (312) 829-6800

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220413000235 IL Practitioner - Optometry 9638565948 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mark L Skowron PCGroup PAC ID 4082793047, 5 clinicians

Practice addresses (Care Compare)

370 N York Rd
Elmhurst, IL 60126-2320

370 N York St
Elmhurst, IL 60126-2320
Phone (630) 834-6244

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.011508ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
HTNB LLC Optometrist CurrentSince Apr 4, 2022 Accepting new patients
Mark L. Skowron PC Optometrist CurrentSince May 1, 2024 Accepting new patients

Locations

942 W Madison St
Chicago, IL 60607
Phone (312) 829-6800

14 S Peoria St
Chicago, IL 60607
Phone (312) 432-0080

370 N York St
Elmhurst, IL 60126
Phone (630) 834-6244

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1194393645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "942 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072601",
            "telephone_number": "312-829-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "942 W MADISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072601",
            "telephone_number": "312-829-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUSOL",
        "first_name": "ALEKSANDRA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.