Individual provider Active NPI

Kristina Koinoglou, OD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1346093861
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011893 Issued in IL
Practice address
555 S Dearborn St
Chicago, IL 60605-1586
Phone
(312) 588-5999
NPI assigned
Apr 8, 2024
Last updated
Aug 20, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046011893 IL Primary

Addresses

Primary practice location

555 S Dearborn St
Chicago, IL 60605-1586

Mailing address

360 W Hubbard St Apt 2003
Chicago, IL 60654-5752
Phone (330) 904-1947

Other practice location 1

3460 S Halsted St
Chicago, IL 60608-6743
Phone (312) 588-5999

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1444 S Michigan Ave
Chicago, IL 60605-4827

2794 Shillingford Cir NW
North Canton, OH 44720-8226

447 W 42ND PL
Chicago, IL 60609-2710

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Solo Eye Care Printers Row, PLLC Optometrist CurrentSince Aug 25, 2024 Accepting new patients
Solo Eye Care Bridgeport PLLC Optometrist Past Accepting new patients

Locations

555 S Dearborn St
Chicago, IL 60605
Phone (312) 588-5999

Organizations & group practices 2

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": "1712534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1346093861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 W HUBBARD ST APT 2003",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606545752",
            "telephone_number": "330-904-1947"
        },
        {
            "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": "312-588-5999"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3460 S Halsted St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606086743",
            "country_code": "US",
            "telephone_number": "312-588-5999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOINOGLOU",
        "first_name": "KRISTINA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-04-08",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011893",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.