Individual provider Active NPI

Mark Thomas McLoughlin, OD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1326261702
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
4642 N Cumberland Ave
Chicago, IL 60656-4237
Phone
(773) 625-3602
Fax
(773) 625-3869
NPI assigned
Apr 11, 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 IL Primary

Addresses

Primary practice location

4642 N Cumberland Ave
Chicago, IL 60656-4237

Mailing address

4642 N Cumberland Ave
Chicago, IL 60656-4237
Phone (773) 625-3602

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071231000374 IL Practitioner - Optometry 9436239688 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046007736ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Clear View Optical Inc. CurrentSince Jul 5, 2015 Accepting new patients

Locations

4642 N Cumberland Ave
Chicago, IL 60656
Phone (773) 625-3602

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": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326261702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4642 N CUMBERLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606564237",
            "telephone_number": "773-625-3602",
            "fax_number": "773-625-3869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4642 N CUMBERLAND AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606564237",
            "telephone_number": "773-625-3602",
            "fax_number": "773-625-3869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLOUGHLIN",
        "first_name": "MARK",
        "middle_name": "THOMAS",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.