Organization Active NPI

Orland Eye, LTD

  • Optometrist
  • Orland Park, IL
National Provider Identifier
1356601041
Registry record updated Aug 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046007647 Issued in IL
Legal business name
ORLAND EYE, LTD
Practice address
15410 S Harlem Ave
Orland Park, IL 60462-4333
Phone
(708) 633-0011
Fax
(708) 633-9111
NPI assigned
May 29, 2012
Last updated
Aug 27, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2012

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

Authorized official

Name
Dr. Gloria Jean Docherty, ODNPI 1083704282
Title
President
Phone
(708) 650-2522

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 046007647 IL Primary

Addresses

Primary practice location

15410 S Harlem Ave
Orland Park, IL 60462-4333

Mailing address

15410 S Harlem Ave
Orland Park, IL 60462-4333
Phone (708) 633-0011

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120705000256 IL Part B Supplier - Clinic/Group Practice 5597920173 Receives reassigned benefits from 2 practitioners
Practice locations: Orland Park, IL

National Provider Directory

National Provider Directory

Locations

15410 S Harlem Ave
Orland Park, IL 60462
Phone (708) 633-0011

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1338249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346025600000",
    "number": "1356601041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15410 S HARLEM AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624333",
            "telephone_number": "708-633-0011",
            "fax_number": "708-633-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15410 S HARLEM AVE",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604624333",
            "telephone_number": "708-633-0011",
            "fax_number": "708-633-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORLAND EYE, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-29",
        "last_updated": "2012-08-27",
        "status": "A",
        "authorized_official_last_name": "DOCHERTY",
        "authorized_official_first_name": "GLORIA",
        "authorized_official_middle_name": "JEAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-650-2522",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.