Glen Ellyn Family Eye Care LLC

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

GLEN ELLYN FAMILY EYE CARE LLC

Practice address

510 N Main St
Glen Ellyn, IL 60137-5104

Phone

(630) 858-3937

NPI assigned

Nov 5, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Tom Panos, ODNPI 1629127881

Title

Optometrist

Phone

(708) 710-0005

Specialties & licenses 1

Addresses

Other names 1

• Glen Ellyn Family Eye Care Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tom G Panos, O.D.

  • Optometrist
  • Glen Ellyn, IL
  • NPI 1629127881
  Medicare reassignment Care Compare group NPD Authorized official
• Regina Schwan

  • Optometrist
  • Glen Ellyn, IL
  • NPI 1780781567
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1604534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604534400000",
    "number": "1366043382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 N MAIN ST",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375104",
            "telephone_number": "630-858-3937"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 N MAIN ST",
            "city": "GLEN ELLYN",
            "state": "IL",
            "postal_code": "601375104",
            "telephone_number": "630-858-3937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLEN ELLYN FAMILY EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-05",
        "last_updated": "2020-11-05",
        "certification_date": "2020-11-05",
        "status": "A",
        "authorized_official_last_name": "PANOS",
        "authorized_official_first_name": "TOM",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "708-710-0005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Glen Ellyn Family Eye Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Allison Gile
• Gina Ruane Prof Corp
• Glen Ellyn C C School Dist 89
• Glen Ellyn Family Dental Care
• Glen Ellyn Family Eye Care Associates LTD
• Glen Ellyn Ophthalmology Associates, LTD.
• Glen Ellyn Orthodontic Associates, P.C.
• Glen Ellyn Orthodontics, PC
• Glen Ellyn Pediatric Dentistry ,P.C..
• Glen Ellyn Pharmacy Inc

• Optometrist in Glen Ellyn, IL
• Providers in Glen Ellyn, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2020; 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.