Individual provider Active NPI

Joy H. Goffron-Kluge, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1275618589
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
46009450 Issued in IL
Practice address
2057 N Clybourn Ave
Chicago, IL 60614-4003
Phone
(773) 477-3475
NPI assigned
Oct 26, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 46009450 IL Primary

Addresses

Primary practice location

2057 N Clybourn Ave
Chicago, IL 60614-4003

Mailing address

2057 N Clybourn Ave
Chicago, IL 60614-4003
Phone (773) 477-3475

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090914000088 IL Practitioner - Optometry 2668528878 Reassigns benefits to 1 organization
I20250226003349 WI Practitioner - Optometry 2668528878 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shoptikal LLCGroup PAC ID 1456684471, shared by 12 NPIs, 192 clinicians

Practice addresses (Care Compare)

1640 Madison Ave
Fort Atkinson, WI 53538-3101
Phone (920) 563-2171

1918 Gateway Ctr Dr
Belvidere, IL 61008-9303
Phone (815) 547-3456

5006 Northwest Hwy
Suite C
Crystal Lake, IL 60014-7339
Phone (779) 205-0315

554 E Illinois Route 173
Antioch, IL 60002-9420
Phone (224) 603-7189

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46009450ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Shoptikal LLC Optometrist CurrentSince Sep 7, 2022 Accepting new patients
Shoptikal LLC Optometrist CurrentSince Jan 20, 2025 Accepting new patients
Shoptikal LLC Optometrist CurrentSince Sep 7, 2022 Accepting new patients
Shoptikal LLC Optometrist Current Accepting new patients
Shoptikal LLC Optometrist Current Accepting new patients

Locations

1918 Gateway Center Dr
Belvidere, IL 61008
Phone (815) 547-3456

1640 Madison Ave
Fort Atkinson, WI 53538
Phone (920) 563-2171

6000 Monona Dr
Ste 101
Monona, WI 53716
Phone (608) 222-9420

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275618589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2057 N CLYBOURN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144003",
            "telephone_number": "773-477-3475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2057 N CLYBOURN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606144003",
            "telephone_number": "773-477-3475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOFFRON-KLUGE",
        "first_name": "JOY",
        "middle_name": "H.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "46009450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.