Albert Ya-Dek Liao, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046010524 Issued in IL

Practice address

3900 Fountain Square PL
Waukegan, IL 60085-6708

Phone

(847) 473-2568

NPI assigned

May 29, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Bravo Eyecare PLLC

  • Optometrist
  • Waukegan, IL
  • NPI 1346023835
  NPD Authorized official

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

{
    "created_epoch": "1212019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1346408176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1416 OXFORD DR",
            "city": "BUFFALO GROVE",
            "state": "IL",
            "postal_code": "600891012",
            "telephone_number": "847-473-2568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 FOUNTAIN SQUARE PL",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600856708",
            "telephone_number": "847-473-2568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIAO",
        "first_name": "ALBERT",
        "middle_name": "YA-DEK",
        "name_prefix": "Mr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-29",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6750TG",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010524",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rasheema Lettsome-Cooper, LCSW, CWMF
• Letz Go Transportation
• Frank K Leung, MD
• Barak Levin
• Donna M Levy, M.S.ED
• Melanie Lima
• Cecilia Limon
• Jwojiun Lin, RN,BSN,MPH
• Kang-Yann Lin, MD
• Cynthia Everet Nichola Lincke, MSW, LCSW

• Optometrist in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.