NPIMap

Organization Active NPI

Wheaton Eye Clinic LTD

  • Ophthalmology Physician
  • Naperville, IL
National Provider Identifier
1497730790
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
WHEATON EYE CLINIC LTD
Practice address
604 Raymond Dr
Naperville, IL 60563-9788
Phone
(630) 668-8250
Fax
(630) 668-8916
NPI assigned
Dec 8, 2005
Organization subpart
Yes
Parent organization
WHEATON EYE CLINIC, LTDAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

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

Authorized official

Name
Lisa White
Title
Credentialing Specialist
Phone
(630) 588-3630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207W00000X IL Primary

Addresses

Primary practice location

604 Raymond Dr
Naperville, IL 60563-9788

Mailing address

2015 N Main St
Wheaton, IL 60187-3152
Phone (630) 668-8250

Other names 2

  • Wheaton Eye Clinic Doing business as
  • Naperville Optical Department Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930001873 IL DME Supplier - Physician - OphthalmologyDME Supplier - Physician - Optometrist 2860475944 Practice locations: Naperville, IL

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Benjamin H Ticho MD4 organizations share this tax ID, including this one
Part of
Benjamin H Ticho MD

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 46

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

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1134000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1497730790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 N MAIN ST",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873152",
            "telephone_number": "630-668-8250",
            "fax_number": "630-668-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 RAYMOND DR",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605639788",
            "telephone_number": "630-668-8250",
            "fax_number": "630-668-8916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHEATON EYE CLINIC LTD",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WHEATON EYE CLINIC, LTD",
        "enumeration_date": "2005-12-08",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "630-588-3630"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wheaton Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Naperville Optical Department",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; 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.