Clinton Roger Prestwich

Primary specialty

OptometristTaxonomy code 152W00000X

License

046011377 Issued in IL

Practice address

3450 Lacey Rd
Downers Grove, IL 60515-5430

Phone

(630) 743-4500

NPI assigned

Jun 30, 2017

Last updated

Oct 7, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialty

Optometry

Education

Southern College of Optometry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwestern UniversityGroup PAC ID 6305734773, 116 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cprestwich18735@direct.midwestern.edu

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.

• Midwestern University

  dba MWU Multispecialty Clinic Downers Grove

  • Clinic/Center
  • Downers Grove, IL
  • NPI 1538445317

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• Midwestern University

  dba Midwestern University Eye Institute-Downers Grove

  • Optometrist
  • Downers Grove, IL
  • NPI 1295126324
  NPD

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

{
    "created_epoch": "1498780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1467973396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 LACEY RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155430",
            "telephone_number": "630-743-4500",
            "fax_number": "630-743-4839"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 LACEY RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155430",
            "telephone_number": "630-743-4500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESTWICH",
        "first_name": "CLINTON",
        "middle_name": "ROGER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-30",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011377",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tammy Michelle Prater, RN
• Alexis Pennacchio Pratt, LCPC
• Jan Prazak, M.S., CCC-SLP
• Precisionimagingusa
• Premier Care LLC
• Preventative Mental Healthcare Services
• Jazmine Price, LMFT
• Rebecca Price, RBT
• Samantha Proctor, LCPC
• Janey Prodoehl

• Optometrist in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.