Individual provider Active NPI

Kathrine Holmberg, O.D

  • Optometrist
  • Chicago Heights, IL
National Provider Identifier
1427427418
Registry record updated Sep 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010888 Issued in IL
Practice address
366 Dixie Hwy
Chicago Heights, IL 60411-1758
Phone
(708) 754-0089
NPI assigned
Sep 19, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010888 IL Primary

Addresses

Primary practice location

366 Dixie Hwy
Chicago Heights, IL 60411-1758

Mailing address

366 Dixie Hwy
Chicago Heights, IL 60411-1758
Phone (708) 754-0089

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
I20150930001064 IL Practitioner - Optometry 0648588376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Holmberg Optometric LTDGroup PAC ID 4284994724, 2 clinicians

Practice addresses (Care Compare)

366 Dixie Hwy
Chicago Heights, IL 60411-1758
Phone (708) 754-0080

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Holmberg Optometric LTD Optometrist CurrentSince Nov 18, 2017 Accepting new patients

Locations

366 Dixie Hwy
Chicago Hts, IL 60411
Phone (708) 754-0080

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1442620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442620800000",
    "number": "1427427418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 DIXIE HWY",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604111758",
            "telephone_number": "708-754-0089"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 DIXIE HWY",
            "city": "CHICAGO HEIGHTS",
            "state": "IL",
            "postal_code": "604111758",
            "telephone_number": "708-754-0089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLMBERG",
        "first_name": "KATHRINE",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-19",
        "last_updated": "2015-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago Heights, IL

Sources for this page

Verify at the official NPI Registry.