Organization Active NPI

Eye Q Vision, Inc

  • Optometrist
  • Sycamore, IL
National Provider Identifier
1487958476
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
46008933 Issued in IL
Legal business name
EYE Q VISION, INC
Practice address
2127 Midlands CT
Unit 101
Sycamore, IL 60178-3173
Phone
(815) 756-4244
Fax
(815) 756-4244
NPI assigned
Jan 5, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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

Authorized official

Name
Dr. Anthony Pete Tsiftilis, O.D.NPI 1740305366
Title
President
Phone
(815) 756-4244

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X 46008933 IL Primary

Addresses

Primary practice location

2127 Midlands CT
Unit 101
Sycamore, IL 60178-3173

Mailing address

2127 Midlands CT
Unit 101
Sycamore, IL 60178-3173
Phone (815) 756-4244

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110112000250 IL Part B Supplier - Clinic/Group Practice 3971792698 Receives reassigned benefits from 1 practitioner
Practice locations: Sycamore, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2120915Eye Q Vision Inc2127 Midlands CT, Ste 101, Sycamore, IL 60178Certificate of waiverOct 25, 2026

National Provider Directory

National Provider Directory

Locations

2127 Midlands Ct
Unit 101
Sycamore, IL 60178
Phone (815) 756-4244

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1294185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303257600000",
    "number": "1487958476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2127 MIDLANDS CT",
            "address_2": "UNIT 101",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783173",
            "telephone_number": "815-756-4244",
            "fax_number": "815-756-4244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2127 MIDLANDS CT",
            "address_2": "UNIT 101",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783173",
            "telephone_number": "815-756-4244",
            "fax_number": "815-756-4244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE Q VISION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-05",
        "last_updated": "2011-04-20",
        "status": "A",
        "authorized_official_last_name": "TSIFTILIS",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "PETE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "815-756-4244",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": "46008933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.