Individual provider Active NPI

Paul A Foreman, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1356310841
Registry record updated Oct 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
6601 N Avondale Ave
Suite 102
Chicago, IL 60631-1572
Phone
(773) 792-1011
Fax
(773) 889-0224
NPI assigned
Mar 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 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

6601 N Avondale Ave
Suite 102
Chicago, IL 60631-1572

Mailing address

6601 N Avondale Ave
Suite 102
Chicago, IL 60631-1572
Phone (773) 792-1011

Other identifiers 1

IdentifierTypeStateIssuer
1622243OtherILBCBS IL GROUP

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046007804ILMDOptometrist
01819IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heath Family Eyecare Inc Optometrist CurrentSince Oct 1, 2018 Accepting new patients
Visionworks, Inc Past Accepting new patients
Foreman & Stack OD PC Optometrist PastSince Jun 1, 2004 Accepting new patients
Senior Eye Associates SC Optometrist PastSince Jul 9, 2007 Accepting new patients
Geriatric Vision Care LLC Optometrist PastSince May 1, 2018 Accepting new patients
James M Noth M.D. , LTD Past Accepting new patients
Visionworks, Inc. Optometrist PastSince Mar 17, 2018 Accepting new patients
Jeffrey S Foreman OD Optometrist PastSince Oct 1, 2018 Accepting new patients

Locations

1511 1st Ave S
Fort Dodge, IA 50501
Phone (515) 955-7777

Organizations & group practices 8

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191196800000",
    "number": "1356310841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6601 N AVONDALE AVE",
            "address_2": "SUITE 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606311572",
            "telephone_number": "773-792-1011",
            "fax_number": "773-889-0224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6601 N AVONDALE AVE",
            "address_2": "SUITE 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606311572",
            "telephone_number": "773-792-1011",
            "fax_number": "773-889-0224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOREMAN",
        "first_name": "PAUL",
        "middle_name": "A",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2007-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL GROUP",
            "identifier": "1622243",
            "state": "IL"
        }
    ],
    "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 Oct 1, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.