Individual provider Active NPI

David Varney, O.D.

  • Optometrist
  • Bolingbrook, IL
National Provider Identifier
1417237488
Registry record updated May 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010458 Issued in IL
Practice address
124 E Boughton Rd
Bolingbrook, IL 60440-2014
Phone
(630) 358-4533
Fax
(360) 348-8133
NPI assigned
Aug 23, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010458 IL Primary

Addresses

Primary practice location

124 E Boughton Rd
Bolingbrook, IL 60440-2014

Mailing address

3759 S Morgan St Unit a
Chicago, IL 60609-1438
Phone (319) 404-7565

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
I20120713000378 IL Practitioner - Optometry 0143485318 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bolingbrook Eye Care and Eyewear Gallery, LLCGroup PAC ID 4082982988, 2 clinicians
Solo Eye Care and Eyewear Gallery, LLCGroup PAC ID 8123043916, 9 clinicians

Practice addresses (Care Compare)

124 E Boughton Rd
Bolingbrook, IL 60440-2014
Phone (630) 358-4533

1444 S Michigan Ave
Chicago, IL 60605-4827
Phone (312) 588-5999

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046010458ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bolingbrook Eye Care & Eyewear Gallery, LLC Optometrist CurrentSince May 22, 2017 Accepting new patients
Solo Eye Care Bridgeport PLLC Optometrist Past Accepting new patients
Rasa Eyecare & Vision Group Inc Optometrist PastSince May 22, 2017 Accepting new patients

Locations

124 E Boughton Rd
Bolingbrook, IL 60440
Phone (630) 358-4533

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1314057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494460800000",
    "number": "1417237488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3759 S MORGAN ST UNIT A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606091438",
            "telephone_number": "319-404-7565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E BOUGHTON RD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402014",
            "telephone_number": "630-358-4533",
            "fax_number": "360-348-8133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VARNEY",
        "first_name": "DAVID",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-08-23",
        "last_updated": "2017-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010458",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.