Individual provider Active NPI

Kathleen L Janssen, O.D.

  • Optometrist
  • Vernon Hills, IL
National Provider Identifier
1346303179
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
2 Hawthorn Ctr
Vernon Hills, IL 60061-1520
Phone
(847) 367-0885
Fax
(847) 367-0394
NPI assigned
Dec 19, 2006
Sex
Female
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

2 Hawthorn Ctr
Vernon Hills, IL 60061-1520

Mailing address

818 Belinder LN Apt 2003
Schaumburg, IL 60173-5280
Phone (773) 501-0104

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
I20240503000211 IL Practitioner - Optometry 0749440113 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-009429ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
West Point Optical Group Optometrist CurrentSince Feb 17, 2024 Accepting new patients

Locations

900 Belvidere Rd
Belvidere, IL 61008
Phone (708) 859-8000

6150 E State St
Ste 130
Rockford, IL 61108
Phone (708) 859-8000

850 E Golf Rd
Schaumburg, IL 60173
Phone (847) 519-1020

246 Hawthorn Village Cmn
Vernon Hills, IL 60061
Phone (847) 680-9160

316 S Hamilton Rd
Gahanna, OH 43230

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": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346303179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 BELINDER LN APT 2003",
            "city": "SCHAUMBURG",
            "state": "IL",
            "postal_code": "601735280",
            "telephone_number": "773-501-0104",
            "fax_number": "847-367-0394"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 HAWTHORN CTR",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611520",
            "telephone_number": "847-367-0885",
            "fax_number": "847-367-0394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSSEN",
        "first_name": "KATHLEEN",
        "middle_name": "L",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-19",
        "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 Vernon Hills, IL

Sources for this page

Verify at the official NPI Registry.