Chrysalis Anaplastology & Ocularistry Inc

Primary specialty

Prosthetic/Orthotic SupplierTaxonomy code 335E00000X

Legal business name

CHRYSALIS ANAPLASTOLOGY & OCULARISTRY INC

Practice address

23605 N High Ridge Dr
Lake Zurich, IL 60047-9048

Phone

(847) 719-2984

NPI assigned

May 22, 2008

Last updated

Aug 30, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Miss Lisa Marie Skowron, BCO, BADO, MAMS, BSNPI 1174720452

Title

President

Phone

(847) 719-2984

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Practitioners 1

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.

• Lisa Marie Skowron, MAMS, BCO, BADO, CCA

  • Specialist
  • Lake Zurich, IL
  • NPI 1174720452
  NPD Authorized official

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314662400000",
    "number": "1407013717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23605 N HIGH RIDGE DR",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600479048",
            "telephone_number": "847-719-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23605 N HIGH RIDGE DR",
            "city": "LAKE ZURICH",
            "state": "IL",
            "postal_code": "600479048",
            "telephone_number": "847-719-2984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRYSALIS ANAPLASTOLOGY & OCULARISTRY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2011-08-30",
        "status": "A",
        "authorized_official_last_name": "SKOWRON",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-719-2984",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "BCO, BADO, MAMS, BS"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF TENNESSEE",
            "identifier": "4112920",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "2941551",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Melissa Ann Colon, PSYD
• Costco Wholesale Corporation

• Prosthetic/Orthotic Supplier in Lake Zurich, IL
• Providers in Lake Zurich, IL by specialty
• Prosthetic/Orthotic Supplier in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.