Individual provider Active NPI

Lamont Mark Sprague, O.D.

  • Corneal and Contact Management Optometrist
  • Crystal Lake, IL
National Provider Identifier
1215009832
Registry record updated Feb 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Corneal and Contact Management OptometristTaxonomy code 152WC0802X
License
046007026 Issued in IL
Practice address
300 Memorial Dr
Suite 300
Crystal Lake, IL 60014-6278
Phone
(815) 459-7110
Fax
(815) 459-7138
NPI assigned
Nov 15, 2006
Last updated
Feb 16, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Corneal and Contact Management Optometrist 152WC0802X 046007026 IL Primary

Addresses

Primary practice location

300 Memorial Dr
Suite 300
Crystal Lake, IL 60014-6278

Mailing address

300 Memorial Dr
Suite 300
Crystal Lake, IL 60014-6278
Phone (815) 459-7110

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046007026ILMDCorneal and Contact Management Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifetime Vision & Contact Lens Center, LTD. Corneal and Contact Management CurrentSince Feb 6, 1985 Accepting new patients

Locations

300 Memorial Dr
Ste 300
Crystal Lake, IL 60014
Phone (815) 459-7110

Interoperability endpoints

  • Direct secure messaging: lmsprague@direct.revolutionehr.com

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, 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": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708041600000",
    "number": "1215009832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MEMORIAL DR",
            "address_2": "SUITE 300",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146278",
            "telephone_number": "815-459-7110",
            "fax_number": "815-459-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MEMORIAL DR",
            "address_2": "SUITE 300",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146278",
            "telephone_number": "815-459-7110",
            "fax_number": "815-459-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPRAGUE",
        "first_name": "LAMONT",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2024-02-16",
        "certification_date": "2024-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IL",
            "license": "046007026",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.