Individual provider Active NPI

Dana Shari Shannon, OD

  • Optometrist
  • Westmont, IL
National Provider Identifier
1194498550
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011530 Issued in IL
Practice address
700 E Ogden Ave Ste 200
Westmont, IL 60559-1296
Phone
(630) 323-7300
NPI assigned
Jul 30, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046011530 IL Primary

Addresses

Primary practice location

700 E Ogden Ave Ste 200
Westmont, IL 60559-1296

Mailing address

5203 S Blackstone Ave BSMT
Chicago, IL 60615-4458
Phone (773) 628-4346

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
I20220727003227 IL Practitioner - Optometry 2365824075 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University Alabama Birmingham - School of Optometry, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Vision Salon, LTD.Group PAC ID 0345143855, 2 clinicians
Clarendon Vision Development CenterGroup PAC ID 5799951745, 3 clinicians

Practice addresses (Care Compare)

12812 Western Ave
Blue Island, IL 60406-2118
Phone (708) 385-0013

700 E Ogden Ave
Suite 200
Westmont, IL 60559-1296
Phone (630) 323-7300

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc. Optometrist CurrentSince Sep 22, 2023 Accepting new patients
Visionworks, Inc CurrentSince Sep 22, 2023 Accepting new patients
Clarendon Vision Development Center CurrentSince Jan 8, 2024 Accepting new patients
The Vision Salon, LTD. Optometrist CurrentSince Jul 13, 2022 Accepting new patients

Locations

12812 Western Ave
Blue Island, IL 60406
Phone (708) 385-0013

239 Golf Mill Ctr
Ste 255
Niles, IL 60714
Phone (847) 297-2286

2422 US Highway 34
Oswego, IL 60543
Phone (630) 551-4133

760 Pasquinelli Dr
Ste 300
Westmont, IL 60559
Phone (630) 323-7300

700 E Ogden Ave
Ste 200
Westmont, IL 60559
Phone (630) 323-7300

Interoperability endpoints

  • Direct secure messaging: drshannon@visionsalon.emadirect.md

Organizations & group practices 4

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": "1627603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727654400000",
    "number": "1194498550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5203 S BLACKSTONE AVE BSMT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154458",
            "telephone_number": "773-628-4346"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E OGDEN AVE STE 200",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591296",
            "telephone_number": "630-323-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANNON",
        "first_name": "DANA",
        "middle_name": "SHARI",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westmont, IL

Sources for this page

Verify at the official NPI Registry.