Edward Patrick Hanlon, O.D.
Individual provider Active NPI Optometrist · Morrison, IL
NPI 1255538153 · NPPES record last updated Aug 9, 2012
Key facts
- NPI
- 1255538153
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 046.009960 (IL)
- Practice address
- 105 S Heaton St
Morrison, IL 61270-2007 - Phone
- (815) 772-8100
- NPI assigned
- Jul 2, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 6
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- CGH Medical Center
Practice addresses (Care Compare)
10 W 3Rd St
Sterling, IL 61081-3503
Phone (815) 632-5300
101 E Miller Rd
Sterling, IL 61081-1252
Phone (815) 625-4790
1319 N Galena Ave
Dixon, IL 61021-1009
Phone (815) 624-4790
1321 N Galena Ave
Dixon, IL 61021-1009
Phone (815) 284-1600
Hospital & facility affiliations
- CGH Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080915000136 | IL | Practitioner - Optometry | 7214003375 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046.009960 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CGH Medical Center | Current |
Accepting new patients | |
| CGH Medical Center | Current |
Accepting new patients | |
| CGH Medical Center | Current | Accepting new patients |
Locations
1321 N Galena Ave
Dixon, IL 61021
Phone (815) 284-1600
105 S Heaton St
Morrison, IL 61270
Phone (815) 284-1600
711 S Division Ave
Polo, IL 61064
Phone (815) 946-3661
10 W 3rd St
Sterling, IL 61081
Phone (815) 226-4990
101 E Miller Rd
Sterling, IL 61081
Phone (815) 632-5285
Interoperability endpoints
- ehanlon19873@cghmc.direct-ci.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046.009960 | IL | Yes |
Addresses
Primary practice location
105 S Heaton St
Morrison, IL 61270-2007
Mailing address
PO Box 554
Milledgeville, IL 61051-0554
Phone (815) 631-7637
Other providers in Morrison, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.