Individual provider Active NPI

Katherine Suzanne Delgadillo, O.D.

  • Optometrist
  • Cary, IL
National Provider Identifier
1194763359
Registry record updated May 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-009455 Issued in IL
Practice address
855 Feinberg CT
Cary, IL 60013-2976
Phone
(847) 516-3111
NPI assigned
Jun 2, 2006
Last updated
May 8, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 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 046-009455 IL Primary

Addresses

Primary practice location

855 Feinberg CT
Cary, IL 60013-2976

Mailing address

2622 W Autumn Dr
Round Lake, IL 60073-5260
Phone (847) 924-5751

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
I20040315000520 IL Practitioner - Optometry 1355230525 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2002
Medicare assignment
May accept Medicare assignment
Group practices
Johnson Eye Care IncGroup PAC ID 7911904099, 3 clinicians

Practice addresses (Care Compare)

855 Feinberg CT
Suite 110
Cary, IL 60013-2976
Phone (847) 516-3111

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery18

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-009455ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson Eye Care Inc Optometrist CurrentSince Nov 1, 2012 Accepting new patients
Tzvecl Inc Optometrist PastSince Jul 1, 2006 Accepting new patients
Praxis Physical Therapy and Human Performance PC Past Accepting new patients

Locations

855 Feinberg Ct
Ste 110
Cary, IL 60013
Phone (847) 516-3111

Organizations & group practices 3

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": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715126400000",
    "number": "1194763359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2622 W AUTUMN DR",
            "city": "ROUND LAKE",
            "state": "IL",
            "postal_code": "600735260",
            "telephone_number": "847-924-5751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 FEINBERG CT",
            "city": "CARY",
            "state": "IL",
            "postal_code": "600132976",
            "telephone_number": "847-516-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELGADILLO",
        "first_name": "KATHERINE",
        "middle_name": "SUZANNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-02",
        "last_updated": "2024-05-08",
        "certification_date": "2024-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, IL

Sources for this page

Verify at the official NPI Registry.