Active NPI
Lindsey Stull, O.D
- Vision Therapy Optometrist
- Naperville, IL
National Provider Identifier
1396940920
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Vision Therapy Optometrist
- License
- 046010926
- Practice address
- 1891 Bay Scott Cir
Suite 109
Naperville, IL 60540-1137 - Phone
- (630) 881-7763
- NPI assigned
- Jun 14, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vision Therapy Optometrist | 152WV0400X | 046010926 | IL | Primary |
| Vision Therapy Optometrist | 152WV0400X | 4901004454 | MI |
Addresses
Primary practice location
1891 Bay Scott Cir
Suite 109
Naperville, IL 60540-1137
Mailing address
1891 Bay Scott Cir
Suite 109
Naperville, IL 60540-1137
Phone (630) 881-7763
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective May 6, 2016 through May 6, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046010926 | IL | MD | Vision Therapy Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Direct Mobile Vision, PLLC | Past | Accepting new patients | |
| Holicki Optical Inc | Vision Therapy | Past | Accepting new patients |
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.
-
- Optometrist
- Aurora, IL
- NPI 1467072942
-
- Durable Medical Equipment & Medical Supplies
- Coldwater, MI
- NPI 1386637957
Vision Therapy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181779200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1454457600000",
"number": "1396940920",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1891 BAY SCOTT CIR",
"address_2": "SUITE 109",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605401137",
"telephone_number": "630-881-7763"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1891 BAY SCOTT CIR",
"address_2": "SUITE 109",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605401137",
"telephone_number": "630-881-7763"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STULL",
"first_name": "LINDSEY",
"credential": "O.D",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-14",
"last_updated": "2016-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "152WV0400X",
"taxonomy_group": "",
"desc": "Optometrist, Vision Therapy",
"state": "IL",
"license": "046010926",
"primary": true
},
{
"code": "152WV0400X",
"taxonomy_group": "",
"desc": "Optometrist, Vision Therapy",
"state": "MI",
"license": "4901004454",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.