Individual provider Active NPI

Johanna Kjestine Lingk, O.D.

  • Optometrist
  • Berwyn, IL
National Provider Identifier
1437313806
Registry record updated Sep 8, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010095 Issued in IL
Practice address
6233 Cermak Rd
Berwyn, IL 60402-2317
Phone
(708) 749-2020
Fax
(708) 749-2069
NPI assigned
Jul 15, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010095 IL Primary

Addresses

Primary practice location

6233 Cermak Rd
Berwyn, IL 60402-2317

Mailing address

6233 Cermak Rd
Berwyn, IL 60402-2317
Phone (708) 749-2020

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
I20080927000242 IL Practitioner - Optometry 1052488376 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Austin-Cleetus LTDGroup PAC ID 2860634011, 3 clinicians

Practice addresses (Care Compare)

17 W685 Roosevelt Rd
Oakbrook Terrace, IL 60181-3545
Phone (630) 916-8282

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046010095ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Rosin Optical Co., Inc. Optometrist CurrentSince Jul 1, 2008 Accepting new patients
Austin-Cleetus LTD Optometrist CurrentSince May 1, 2021 Accepting new patients
Rosin Optical Co. Inc. Optometrist CurrentSince Jul 1, 2008 Accepting new patients
Gervais-Floyd, LTD Optometrist CurrentSince May 1, 2023 Accepting new patients
Rosin Optical Co., Inc Optometrist Current Accepting new patients

Locations

6235 Cermak Rd
Berwyn, IL 60402
Phone (708) 749-2020

145 Ogden Ave
Downers Grove, IL 60515
Phone (630) 749-2020

705 E Ogden Ave
Naperville, IL 60563
Phone (630) 388-6606

17W685 Roosevelt Rd
Oakbrook Terrace, IL 60181
Phone (630) 916-8282

24 Orland Square Dr
Orland Park, IL 60462
Phone (708) 403-3555

Organizations & group practices 5

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": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252368000000",
    "number": "1437313806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6233 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022317",
            "telephone_number": "708-749-2020",
            "fax_number": "708-749-2069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6233 CERMAK RD",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022317",
            "telephone_number": "708-749-2020",
            "fax_number": "708-749-2069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINGK",
        "first_name": "JOHANNA",
        "middle_name": "KJESTINE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-15",
        "last_updated": "2009-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berwyn, IL

Sources for this page

Verify at the official NPI Registry.