Individual provider Active NPI

Tanya Halikias, O.D.

  • Optometrist
  • Western Springs, IL
National Provider Identifier
1255539292
Registry record updated Feb 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009983 Issued in IL
Practice address
5450 Wolf Rd
Western Springs, IL 60558-1852
Phone
(312) 949-7168
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009983 IL Primary

Addresses

Primary practice location

5450 Wolf Rd
Western Springs, IL 60558-1852

Mailing address

5450 Wolf Rd
Western Springs, IL 60558-1852
Phone (708) 820-2020

Other identifiers 1

IdentifierTypeStateIssuer
046009983MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070816000771 IL Practitioner - Optometry 8527150887 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

5450 Wolf Rd
Western Springs, IL 60558-1852
Phone (708) 820-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009983ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois College of Optometry Optometrist CurrentSince Jul 1, 2007 Accepting new patients

Locations

3241 S Michigan Ave
Chicago, IL 60616
Phone (312) 225-6200

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519344000000",
    "number": "1255539292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5450 WOLF RD",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581852",
            "telephone_number": "708-820-2020",
            "fax_number": "708-820-0321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5450 WOLF RD",
            "city": "WESTERN SPRINGS",
            "state": "IL",
            "postal_code": "605581852",
            "telephone_number": "312-949-7168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALIKIAS",
        "first_name": "TANYA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2018-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009983",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009983",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Western Springs, IL

Sources for this page

Verify at the official NPI Registry.