Active NPI
David E Cavender, O.D.
- Optometrist
- Calumet City, IL
National Provider Identifier
1356413173
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046008327
- Practice address
- 1700 E West Rd
Calumet City, IL 60409-5415 - Phone
- (708) 891-3330
- Fax
- (708) 891-0904
- NPI assigned
- Nov 15, 2006
- Last updated
- Mar 26, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046008327 | IL | Primary |
Addresses
Primary practice location
1700 E West Rd
Calumet City, IL 60409-5415
Mailing address
1700 E West Rd
Calumet City, IL 60409-5415
Phone (708) 891-3330
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 046008327 | Medicaid | IL | |
| 436350006 | Other | IL | MEDICARE PTAN |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046008327 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Visionworks, Inc | Current | Accepting new patients | |
| Visionworks, Inc. | Optometrist | Current | Accepting new patients |
Locations
239 Golf Mill Ctr
Ste 255
Niles, IL 60714
Phone (847) 297-2286
2422 US Highway 34
Oswego, IL 60543
Phone (630) 551-4133
7208 191st St
Tinley Park, IL 60487
Phone (815) 464-0668
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": "1163548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1395792000000",
"number": "1356413173",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1700 E WEST RD",
"city": "CALUMET CITY",
"state": "IL",
"postal_code": "604095415",
"telephone_number": "708-891-3330",
"fax_number": "708-891-0904"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 E WEST RD",
"city": "CALUMET CITY",
"state": "IL",
"postal_code": "604095415",
"telephone_number": "708-891-3330",
"fax_number": "708-891-0904"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAVENDER",
"first_name": "DAVID",
"middle_name": "E",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-15",
"last_updated": "2014-03-26",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046008327",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "046008327",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "436350006",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Calumet City, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2014; 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.