Individual provider Active NPI

Deanne Lynne Shvartsman, O.D.

  • Optometrist
  • Skokie, IL
National Provider Identifier
1386755585
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046008662 Issued in IL
Practice address
9630 Kenton Ave
Skokie, IL 60076-1216
Phone
(847) 423-2191
Fax
(847) 810-0041
NPI assigned
Aug 31, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046008662 IL Primary

Addresses

Primary practice location

9630 Kenton Ave
Skokie, IL 60076-1216

Mailing address

9630 Kenton Ave
Skokie, IL 60076-1216
Phone (847) 423-2191

Other practice location 1

120 Skokie Blvd
Wilmette, IL 60091-3050
Phone (847) 251-3330

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
I20071219000454 IL Practitioner - Optometry 7113017757 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9630 Kenton Ave
Skokie, IL 60076-1216
Phone (847) 423-2191

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1386755585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9630 KENTON AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761216",
            "telephone_number": "847-423-2191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9630 KENTON AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761216",
            "telephone_number": "847-423-2191",
            "fax_number": "847-810-0041"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "120 Skokie Blvd",
            "address_purpose": "LOCATION",
            "city": "Wilmette",
            "state": "IL",
            "postal_code": "600913050",
            "country_code": "US",
            "telephone_number": "847-251-3330",
            "fax_number": "847-251-9580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHVARTSMAN",
        "first_name": "DEANNE",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008662",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.