Individual provider Active NPI

John James O'Neill, O.D.

  • Optometrist
  • Crystal Lake, IL
National Provider Identifier
1356503403
Registry record updated Jun 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.010068 Issued in IL
Practice address
4002 Wyndwood Dr
Crystal Lake, IL 60014-6545
Phone
(815) 245-2560
NPI assigned
Jun 30, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 30, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.010068 IL Primary

Addresses

Primary practice location

4002 Wyndwood Dr
Crystal Lake, IL 60014-6545

Mailing address

4002 Wyndwood Dr
Crystal Lake, IL 60014-6545
Phone (815) 245-2560

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
I20241017001812 IL Practitioner - Optometry 8224106885 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christina J. Levi O D P C.Group PAC ID 9436210762, 63 clinicians

Practice addresses (Care Compare)

165 S Randall Rd
Elgin, IL 60123-5551
Phone (847) 888-1555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.010068ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Christina J. Levi O D P C Optometrist CurrentSince Aug 8, 2024 Accepting new patients
Christina J. Levi O D P C Optometrist Past Accepting new patients

Locations

2100 Troy Rd
Edwardsville, IL 62025
Phone (618) 656-8888

165 S Randall Rd
Elgin, IL 60123
Phone (847) 888-1555

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1356503403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4002 WYNDWOOD DR",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146545",
            "telephone_number": "815-245-2560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4002 WYNDWOOD DR",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600146545",
            "telephone_number": "815-245-2560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'NEILL",
        "first_name": "JOHN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.010068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.