Organization Active NPI

R a Vision Corporation

Doing business as Uptown Family Vision

  • Optometrist
  • Park Ridge, IL
National Provider Identifier
1255172334
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
R A VISION CORPORATION
Doing business as
Uptown Family Vision
Practice address
118 Main St
Park Ridge, IL 60068-4030
Phone
(847) 696-6444
NPI assigned
Jun 4, 2024
Last updated
Jun 4, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Authorized official

Name
R P
Title
OD
Phone
(847) 696-6444

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

118 Main St
Park Ridge, IL 60068-4030

Mailing address

118 Main St
Park Ridge, IL 60068-4030

Other names 1

  • Uptown Family Vision Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250509002938 IL Part B Supplier - Clinic/Group Practice 8325565559 Receives reassigned benefits from 2 practitioners
Practice locations: Park Ridge, IL

National Provider Directory

National Provider Directory

Locations

118 Main St
Park Ridge, IL 60068
Phone (847) 696-6444

Practitioners & affiliated clinicians

Practitioners 4

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": "1717459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717459200000",
    "number": "1255172334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 MAIN ST",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MAIN ST",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600684030",
            "telephone_number": "847-696-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "R A VISION CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-04",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A",
        "authorized_official_last_name": "P",
        "authorized_official_first_name": "R",
        "authorized_official_title_or_position": "OD",
        "authorized_official_telephone_number": "847-696-6444"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Uptown Family Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Park Ridge, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.