Organization Active NPI

Johnson Eye Care Inc

  • Optometrist
  • Cary, IL
National Provider Identifier
1235222340
Registry record updated Mar 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
JOHNSON EYE CARE INC
Practice address
855 Feinberg CT
Ste 110
Cary, IL 60013
Phone
(847) 516-3111
Fax
(847) 516-3133
NPI assigned
Oct 2, 2006
Last updated
Mar 31, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2011

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

Authorized official

Name
Mrs. Jeanne A Donahue
Title
Office Manager
Phone
(847) 516-3111

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X IL Primary

Addresses

Primary practice location

855 Feinberg CT
Ste 110
Cary, IL 60013

Mailing address

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

Other identifiers 2

IdentifierTypeStateIssuer
046009339MedicaidIL
046007318MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20061102000366 IL Part B Supplier - Clinic/Group Practice 7911904099 Receives reassigned benefits from 4 practitioners
Practice locations: Cary, IL

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2074131Johnson Eye Care855 Feinberg CT, Cary, IL 60013Certificate of waiverOct 26, 2027

National Provider Directory

National Provider Directory

Locations

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

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301529600000",
    "number": "1235222340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 FEINBERG CT",
            "address_2": "STE 110",
            "city": "CARY",
            "state": "IL",
            "postal_code": "60013",
            "telephone_number": "847-516-3111",
            "fax_number": "847-516-3133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 FEINBERG CT",
            "address_2": "STE 110",
            "city": "CARY",
            "state": "IL",
            "postal_code": "60013",
            "telephone_number": "847-516-3111",
            "fax_number": "847-516-3133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON EYE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-03-31",
        "status": "A",
        "authorized_official_last_name": "DONAHUE",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "847-516-3111",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009339",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046007318",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cary, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2011; 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.