Active NPI
Leonard M. Randazzo, O.D.
- Optometrist
- Norridge, IL
National Provider Identifier
1508906868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 46008337
- Practice address
- 4135 N Harlem Ave
Norridge, IL 60706-1211 - Phone
- (708) 457-1113
- Fax
- (708) 457-8528
- NPI assigned
- Feb 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 46008337 | IL | Primary |
Addresses
Primary practice location
4135 N Harlem Ave
Norridge, IL 60706-1211
Mailing address
4135 N Harlem Ave
Norridge, IL 60706-1211
Phone (708) 457-1113
Medicare participation
Medicare enrollment files- 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140429000519 | IL | Practitioner - Optometry | 3577796515 | Practice locations: Norridge, IL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46008337 | IL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1505260800000",
"number": "1508906868",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4135 N HARLEM AVE",
"city": "NORRIDGE",
"state": "IL",
"postal_code": "607061211",
"telephone_number": "708-457-1113",
"fax_number": "708-457-8528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4135 N HARLEM AVE",
"city": "NORRIDGE",
"state": "IL",
"postal_code": "607061211",
"telephone_number": "708-457-1113",
"fax_number": "708-457-8528"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDAZZO",
"first_name": "LEONARD",
"middle_name": "M.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-07",
"last_updated": "2017-09-13",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "46008337",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norridge, IL
- Presence Ambulatory Services (Presence Immediate Care Center - Norridge)
- Presence Ambulatory Services
- Lucas Pritzl, PT
- Katherine Prokop, CCC-SLP
- Katarzyna Pszczola
- Christine Remoquillo, PT
- Resurrection Services (Resurrection Primary Care)
- Resurrection Services (Norridge Family Practice)
- Resurrection Services (Resurrection Immediate Care Center Norridge)
- Resurrection Westlake Hospital
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2017; 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.