Individual provider Active NPI

Stephen M Combs, O.D.

  • Optometrist
  • Streamwood, IL
National Provider Identifier
1356430631
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-008019 Issued in IL
Practice address
75 S Sutton Rd
Streamwood, IL 60107-3367
Phone
(630) 837-8300
Fax
(630) 837-9146
NPI assigned
Oct 12, 2006
Last updated
May 21, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-008019 IL Primary

Addresses

Primary practice location

75 S Sutton Rd
Streamwood, IL 60107-3367

Mailing address

75 S Sutton Rd
Streamwood, IL 60107-3367
Phone (630) 837-8300

Other identifiers 2

IdentifierTypeStateIssuer
0467360001OtherILASF
01620245OtherILBCBS IL

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
046-008019ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Primary Eye Care, LTD. Optometrist PastSince Jan 11, 1992 Accepting new patients

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, 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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1356430631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 S SUTTON RD",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601073367",
            "telephone_number": "630-837-8300",
            "fax_number": "630-837-9146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 S SUTTON RD",
            "city": "STREAMWOOD",
            "state": "IL",
            "postal_code": "601073367",
            "telephone_number": "630-837-8300",
            "fax_number": "630-837-9146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMBS",
        "first_name": "STEPHEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008019",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASF",
            "identifier": "0467360001",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS IL",
            "identifier": "01620245",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Streamwood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; 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.