Individual provider Active NPI

Sandra L. Bury, O.D.

  • Optometrist
  • Oak Lawn, IL
National Provider Identifier
1356524888
Registry record updated Dec 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
04608858 Issued in IL
Practice address
6209 W 95TH St
Oak Lawn, IL 60453-2701
Phone
(708) 423-2500
NPI assigned
Dec 6, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 7, 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 04608858 IL Primary

Addresses

Primary practice location

6209 W 95TH St
Oak Lawn, IL 60453-2701

Mailing address

6209 W 95TH St
Oak Lawn, IL 60453-2701
Phone (708) 423-2500

Other identifiers 1

IdentifierTypeStateIssuer
01621221OtherILBC/BS

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
I20100901000441 IL Practitioner - Optometry 6406859602 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Complete Vision Care PCGroup PAC ID 1052314259, 3 clinicians

Practice addresses (Care Compare)

6209 W 95TH St
Oak Lawn, IL 60453-2701
Phone (708) 423-2500

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04608858ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Complete Vision Care PC Optometrist CurrentSince Feb 9, 1996 Accepting new patients

Locations

6209 W 95th St
Oak Lawn, IL 60453
Phone (708) 423-2500

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1196899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196985600000",
    "number": "1356524888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6209 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532701",
            "telephone_number": "708-423-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6209 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532701",
            "telephone_number": "708-423-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURY",
        "first_name": "SANDRA",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-06",
        "last_updated": "2007-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "04608858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "01621221",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.