Individual provider Active NPI

Anthony Losurdo, O.D.

  • Optometrist
  • Downers Grove, IL
National Provider Identifier
1316095995
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
46008318 Issued in IL
Practice address
1402 Butterfield Rd
Butterfield Plaza
Downers Grove, IL 60515-1031
Phone
(630) 629-2025
Fax
(630) 629-7640
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

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 46008318 IL Primary

Addresses

Primary practice location

1402 Butterfield Rd
Butterfield Plaza
Downers Grove, IL 60515-1031

Mailing address

2935 Braemore Dr
West Chicago, IL 60185-6437
Phone (630) 740-1149

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
I20070606000235 IL Practitioner - Optometry 9436257078 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46008318ILMDOptometrist

Organizations & group practices 1

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1316095995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2935 BRAEMORE DR",
            "city": "WEST CHICAGO",
            "state": "IL",
            "postal_code": "601856437",
            "telephone_number": "630-740-1149",
            "fax_number": "630-629-2045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1402 BUTTERFIELD RD",
            "address_2": "BUTTERFIELD PLAZA",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605151031",
            "telephone_number": "630-629-2025",
            "fax_number": "630-629-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOSURDO",
        "first_name": "ANTHONY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "46008318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Downers Grove, IL

Sources for this page

Verify at the official NPI Registry.