Warrenville Eyecare LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036126563 Issued in IL

Legal business name

WARRENVILLE EYECARE LLC

Practice address

2S631 Rte 59
Warrenville, IL 60555-1441

Phone

(630) 393-7100

NPI assigned

Nov 29, 2012

Last updated

Dec 13, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lisa NijmNPI 1427260975

Title

Owner

Phone

(630) 393-7100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lisa M Nijm, MD

  • Ophthalmology Physician
  • Springfield, IL
  • NPI 1427260975
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1354147200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1481587200000",
    "number": "1457696577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2S631 RTE 59",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605551441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2S631 RTE 59",
            "city": "WARRENVILLE",
            "state": "IL",
            "postal_code": "605551441",
            "telephone_number": "630-393-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARRENVILLE EYECARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-29",
        "last_updated": "2016-12-13",
        "status": "A",
        "authorized_official_last_name": "NIJM",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-393-7100"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036126563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ciara Ward, LCSW
• Joshua J. Ward, M.D.
• Keri L. Warehime, OT
• Maxwell Taylor Warren, DC
• Nicole Warren, PA-C
• Warrenville Fire Protection District
• Warrenville Primary Care
• David H Watt, MD
• Corinna Elisabeth Sophie Weckerle, M.D.
• Jennifer Wegloski, CCC-SLP

• Ophthalmology Physician in Warrenville, IL
• Providers in Warrenville, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.