Gustafson Eye Care Clinics, LTD.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046008241 Issued in IL

Legal business name

GUSTAFSON EYE CARE CLINICS, LTD.

Practice address

96 W Northwest Hwy
Palatine, IL 60067-3571

Phone

(847) 358-7722

Fax

(847) 520-3280

NPI assigned

May 30, 2007

Last updated

Mar 13, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Thomas Earl Gustafson, O.D.NPI 1164492096

Title

President

Phone

(847) 638-7308

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas Earl Gustafson, O.D.

  • Optometrist
  • Palatine, IL
  • NPI 1164492096
  Medicare reassignment Care Compare group NPD Authorized official
• Kelly D Oliver-Ernst, O.D.

  • Optometrist
  • Lake Zurich, IL
  • NPI 1487967329
  Medicare reassignment Care Compare group NPD
• Rachel Hutchins, O.D.

  • Optometrist
  • Iowa City, IA
  • NPI 1023270998

  IL

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1584057600000",
    "number": "1215138771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 W NORTHWEST HWY",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600673571",
            "telephone_number": "847-358-7722",
            "fax_number": "847-520-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 W NORTHWEST HWY",
            "city": "PALATINE",
            "state": "IL",
            "postal_code": "600673571",
            "telephone_number": "847-358-7722",
            "fax_number": "847-520-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUSTAFSON EYE CARE CLINICS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A",
        "authorized_official_last_name": "GUSTAFSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "EARL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-638-7308",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008241",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8241",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dr.gustafson@gustafsoneye.eyefinitydirect.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "96 W Northwest Hwy",
            "city": "Palatine",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600673571",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Alicia Jane Grundy, DC
• Jyoti Mediratta Guerrera, M.H.S., CCC-SLP
• Guided Path Psychological Services, LLC
• Jessica Gul, LCSW
• Jane Margaret Gulino, LCSW
• Thomas Earl Gustafson, O.D.
• Salvador Gutierrez, PHARMD
• Hadukaycare.Inc
• Leeann Hahn
• Elizabeth Haines, M.S., LCPC, NCC

• Optometrist in Palatine, IL
• Providers in Palatine, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.