DO J Pak, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046010380 Issued in IL

Practice address

3333 W Touhy Ave
Lincolnwood Town Ctr
Lincolnwood, IL 60712-2721

Phone

(847) 675-8637

NPI assigned

Jul 19, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

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.

• Luxottica of America Inc.

  • Point of Service
  • Mason, OH
  • NPI 1831244953

  IL

  Medicare reassignment

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

{
    "created_epoch": "1279497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279497600000",
    "number": "1457664591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 S MICHIGAN AVE",
            "address_2": "APT 308",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163261",
            "telephone_number": "312-622-8968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 W TOUHY AVE",
            "address_2": "LINCOLNWOOD TOWN CTR",
            "city": "LINCOLNWOOD",
            "state": "IL",
            "postal_code": "607122721",
            "telephone_number": "847-675-8637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAK",
        "first_name": "DO",
        "middle_name": "J",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-19",
        "last_updated": "2010-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fabio Ortega, M.D.
• Orthopaedic Specialists of the North Shore, LLC
• Orthopaedic Specialists of the Northshore, LLC
• Jesus Ivan Pacheco-Sierra
• Audrey Paik
• Fred J Palmer, D.C.
• Jennifer Ruth Pantelios
• Jianna Papazafeiropoulos
• Yogesh Parikh, MD
• Susana Parraguirre

• Optometrist in Lincolnwood, IL
• Providers in Lincolnwood, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.