Individual provider Active NPI

Nae Hyon Kwon, O.D.

  • Optometrist
  • Lindenhurst, IL
National Provider Identifier
1306886932
Registry record updated Apr 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009464 Issued in IL
Practice address
2120 E Grand Ave
Lindenhurst, IL 60046-9030
Phone
(847) 356-2900
NPI assigned
Jun 8, 2006
Last updated
Apr 25, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009464 IL Primary

Addresses

Primary practice location

2120 E Grand Ave
Lindenhurst, IL 60046-9030

Mailing address

2120 E Grand Ave
Lindenhurst, IL 60046-9030
Phone (847) 356-2900

Other names 1

  • Jason Kwon Professional name

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
I20041203000330 IL Practitioner - Optometry 6305802109 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
Accuvision Center IncGroup PAC ID 3870567936, 4 clinicians

Practice addresses (Care Compare)

1914 E Grand Ave
Lindenhurst, IL 60046-7822
Phone (847) 356-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009464ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Accu-Vision Center Inc. Optometrist CurrentSince Nov 1, 2004 Accepting new patients
Accu-Vision Center Inc. Optometrist PastSince Nov 5, 2023 Accepting new patients
Accu-Vision Center Inc. Optometrist Past Accepting new patients

Locations

1914 E Grand Ave
Lindenhurst, IL 60046
Phone (847) 356-2020

2120 E Grand Ave
Lindenhurst, IL 60046
Phone (847) 356-2020

824 N Il Route 83
Mundelein, IL 60060
Phone (847) 362-2020

2183 N State Route 83
Round Lake Beach, IL 60073
Phone (847) 223-2020

Interoperability endpoints

  • Direct secure messaging: jason.kwon@uprisedirect.com

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, 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": "1149724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1306886932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2120 E GRAND AVE",
            "city": "LINDENHURST",
            "state": "IL",
            "postal_code": "600469030",
            "telephone_number": "847-356-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2120 E GRAND AVE",
            "city": "LINDENHURST",
            "state": "IL",
            "postal_code": "600469030",
            "telephone_number": "847-356-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWON",
        "first_name": "NAE HYON",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-08",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JASON",
            "last_name": "KWON",
            "credential": "O.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Lindenhurst, IL

Sources for this page

Verify at the official NPI Registry.