NPIMap

Organization Active NPI

Chittick Family Eye Care LTD

  • Ophthalmology Physician
  • Danville, IL
National Provider Identifier
1336246552
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
CHITTICK FAMILY EYE CARE LTD
Practice address
1104 N Vermilion St
Danville, IL 61832-3094
Phone
(217) 398-2020
Fax
(217) 442-0119
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Authorized official

Name
Dr. Shawn P Mallady, ODNPI 1891772331
Title
President
Phone
(508) 837-3790

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X Primary
Glaucoma Specialist (Ophthalmology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207WX0009X
Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208600000X

Addresses

Primary practice location

1104 N Vermilion St
Danville, IL 61832-3094

Mailing address

1104 N Vermilion St
Danville, IL 61832-3094
Phone (217) 398-2020

Other names 1

  • Leon Optometric Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040525000487 IL Part B Supplier - Clinic/Group Practice 8628059995 Receives reassigned benefits from 18 practitioners
Practice locations: Savoy, IL; Watseka, IL; Villa Grove, IL; St. Joseph, IL; Rantoul, IL; Paris, IL; Lincoln, IL; Hoopeston, IL…
O20100930017013 IL DME Supplier - Physician - OptometristDME Supplier - Optician 8628059995 Practice locations: Danville, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Chittick Family Eye Care LTD1104 N Vermilion St, Danville, IL 61832-3094(274) 442-2631 Prosthetic Lenses: Conventional Eyeglasses|Prosthetic Lenses: Conventional Contact Lenses|Prosthetic Lenses: Prosthetics Cataract Lenses Accepts assignmentParticipating since Nov 29, 1990

National Provider Directory

National Provider Directory

Locations

111 E Main St
Arcola, IL 61910
Phone (217) 442-2631

159 N Vermilion St
Danville, IL 61832
Phone (217) 442-2631

1104 N Vermilion St
Danville, IL 61832
Phone (217) 398-2020

851 E Orange St
Hoopeston, IL 60942
Phone (217) 283-7611

327 N Kickapoo St
Lincoln, IL 62656
Phone (217) 735-2020

122 W Court St
Paris, IL 61944
Phone (217) 921-3140

1291 E Grove Ave
Rantoul, IL 61866
Phone (217) 892-2727

1287 E Grove Ave
Rantoul, IL 61866
Phone (217) 892-2727

209 E Grove Ave
Rantoul, IL 61866
Phone (217) 892-2727

112 E Walnut St
Watseka, IL 60970
Phone (815) 432-2020

112 E Walnut St
Ste C
Watseka, IL 60970
Phone (815) 432-2266

121 W Walnut St
Watseka, IL 60970

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1731974400000",
    "number": "1336246552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 N VERMILION ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323094",
            "telephone_number": "217-398-2020",
            "fax_number": "217-442-0119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1104 N VERMILION ST",
            "city": "DANVILLE",
            "state": "IL",
            "postal_code": "618323094",
            "telephone_number": "217-398-2020",
            "fax_number": "217-442-0119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHITTICK FAMILY EYE CARE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A",
        "authorized_official_last_name": "MALLADY",
        "authorized_official_first_name": "SHAWN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-837-3790",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207WX0009X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology, Glaucoma Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Leon Optometric Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Leon Optometric Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Danville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.