Richard Mark Zajicek, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046007387 Issued in IL

Practice address

3141 S Veterans Pkwy
Springfield, IL 62704-6565

Phone

(217) 793-2273

Fax

(217) 793-2278

NPI assigned

Feb 1, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Eye Boutique, LLC

  • Optometrist
  • Crystal Lake, IL
  • NPI 1679721591
  NPD (past)
• Visionworks, Inc.

  • Optometrist
  • Niles, IL
  • NPI 1831115906
  NPD (past)
• Visionworks, Inc

  • Eyewear Supplier
  • Simpsonville, SC
  • NPI 1699571166
  NPD (past)

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1255479358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 WELLINGTON AVE",
            "address_2": "UNIT 415",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600073366",
            "telephone_number": "847-340-0877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3141 S VETERANS PKWY",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627046565",
            "telephone_number": "217-793-2273",
            "fax_number": "217-793-2278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZAJICEK",
        "first_name": "RICHARD",
        "middle_name": "MARK",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL ANCILLARY LIC ALGONQUI",
            "identifier": "047933072",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE GENERAL LICENSE",
            "identifier": "046007387",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "1684405",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE THERAPEUTIC LICENSE",
            "identifier": "346000315",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL ANC THERAP ALGONQUIN",
            "identifier": "346002621",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Allison Nicole Yu, MD
• William R Yu, MD
• Brett Harris Yurcisin, PHARMD
• Farid Zahedieh, M.D.
• Syed Muhammad Raza Zaidi
• Antonios Zakharia, M.D.
• Shahrear Zaman, M.D.
• Megan F Zanger, CFNP
• Vincent J Zata, MD
• Tareq Zaza, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.