Active NPI
Haley Loretta Boswick, OD
- Optometrist
- Norridge, IL
National Provider Identifier
1528626769
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046011304
- Practice address
- 4214 N Harlem Ave
Norridge, IL 60706-1293 - Phone
- (708) 453-7005
- NPI assigned
- Jun 3, 2019
- Last updated
- Jun 3, 2019
- Sex
- Female
- Sole proprietor
- No
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 | 046011304 | IL | Primary |
Addresses
Primary practice location
4214 N Harlem Ave
Norridge, IL 60706-1293
Mailing address
100 E 14TH St Apt 1403
Chicago, IL 60605-3672
Phone (224) 600-4846
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046011304 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc | Past | Accepting new patients | |
| Luxottica of America Inc. | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559520000000",
"number": "1528626769",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 E 14TH ST APT 1403",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606053672",
"telephone_number": "224-600-4846"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4214 N HARLEM AVE",
"city": "NORRIDGE",
"state": "IL",
"postal_code": "607061293",
"telephone_number": "708-453-7005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSWICK",
"first_name": "HALEY",
"middle_name": "LORETTA",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-06-03",
"last_updated": "2019-06-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046011304",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norridge, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.