Individual provider Active NPI

Steven Barry Eiden, O.D.

  • Optometrist
  • Deerfield, IL
National Provider Identifier
1457342685
Registry record updated Jun 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046007419 Issued in IL
Practice address
360 S Waukegan Rd
Suite a
Deerfield, IL 60015-5654
Phone
(847) 412-0311
Fax
(847) 412-0316
NPI assigned
Nov 5, 2005
Last updated
Jun 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046007419 IL Primary

Addresses

Primary practice location

360 S Waukegan Rd
Suite a
Deerfield, IL 60015-5654

Mailing address

360 S Waukegan Rd
Suite a
Deerfield, IL 60015-5654
Phone (847) 412-0311

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
I20100716000389 IL Practitioner - Optometry 1254353683 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046007419ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Christina J. Levi O D P C Optometrist CurrentSince Oct 21, 2021 Accepting new patients
Park Ridge North Suburban Vision Consultants LLC Optometrist Current Accepting new patients
Christina J. Levi O D P C Optometrist Past Accepting new patients

Locations

360 S Waukegan Rd
Ste A
Deerfield, IL 60015
Phone (847) 412-0311

2100 Troy Rd
Edwardsville, IL 62025
Phone (618) 656-8888

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1131148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307577600000",
    "number": "1457342685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 S WAUKEGAN RD",
            "address_2": "SUITE A",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155654",
            "telephone_number": "847-412-0311",
            "fax_number": "847-412-0316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "360 S WAUKEGAN RD",
            "address_2": "SUITE A",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600155654",
            "telephone_number": "847-412-0311",
            "fax_number": "847-412-0316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIDEN",
        "first_name": "STEVEN",
        "middle_name": "BARRY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-05",
        "last_updated": "2011-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007419",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deerfield, IL

Sources for this page

Verify at the official NPI Registry.