Elite Eye Care, LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

ELITE EYE CARE, LLC

Practice address

555 S Dearborn St
Chicago, IL 60605-1586

Phone

(312) 614-2020

Fax

(312) 626-5139

NPI assigned

Nov 5, 2018

Last updated

Dec 3, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Matthew Daniel Pietruszka, ODNPI 1679001101

Title

Sole Owner

Phone

(708) 256-5135

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Matthew Daniel Pietruszka, OD

  • Optometrist
  • Chicago, IL
  • NPI 1679001101
  Authorized official Same address or phone

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

{
    "created_epoch": "1541376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543795200000",
    "number": "1306314794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5438 S 74TH AVE",
            "city": "SUMMIT",
            "state": "IL",
            "postal_code": "605011013",
            "telephone_number": "312-614-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S DEARBORN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606051586",
            "telephone_number": "312-614-2020",
            "fax_number": "312-626-5139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE EYE CARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-05",
        "last_updated": "2018-12-03",
        "status": "A",
        "authorized_official_last_name": "PIETRUSZKA",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "SOLE OWNER",
        "authorized_official_telephone_number": "708-256-5135",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; 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.