Individual provider Active NPI

Michael J Wojciak, O.D.

  • Optometrist
  • Schaumburg, IL
National Provider Identifier
1295877132
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.007953 Issued in IL
Practice address
3 Woodfield Mall
Jcpenney Optical
Schaumburg, IL 60173-5012
Phone
(847) 240-5655
Fax
(847) 240-5156
NPI assigned
Feb 13, 2007
Sex
Male
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 046.007953 IL Primary

Addresses

Primary practice location

3 Woodfield Mall
Jcpenney Optical
Schaumburg, IL 60173-5012

Mailing address

7513 Baimbridge Dr
Downers Grove, IL 60516-4453
Phone (630) 241-1937

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
I20080902000102 IL Practitioner - Optometry 4981770765 Practice locations: Rolling Meadows, IL

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1301 Meijer Dr
Rolling Meadows, IL 60008-4205
Phone (847) 593-2406

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.007953ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Usv Optical Inc Past Accepting new patients
US Vision Optical Inc Past Accepting new patients
Usv Optical Inc Optometrist Past Accepting new patients

Organizations & group practices 3

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": "1171324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295877132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7513 BAIMBRIDGE DR",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605164453",
            "telephone_number": "630-241-1937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WOODFIELD MALL",
            "address_2": "JCPENNEY OPTICAL",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735012",
            "telephone_number": "847-240-5655",
            "fax_number": "847-240-5156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOJCIAK",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.007953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Schaumburg, IL

Sources for this page

Verify at the official NPI Registry.