Individual provider Active NPI

Emily Davis, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1538573159
Registry record updated Apr 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.010803 Issued in IL
Practice address
25 E Washington St
Suite 820
Chicago, IL 60602-1708
Phone
(312) 848-4604
NPI assigned
Jun 12, 2014
Last updated
Apr 17, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 17, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.010803 IL Primary

Addresses

Primary practice location

25 E Washington St
Suite 820
Chicago, IL 60602-1708

Mailing address

25 E Washington St
Suite 820
Chicago, IL 60602-1708
Phone (312) 848-4604

Other identifiers 1

IdentifierTypeStateIssuer
046010803MedicaidIL

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140825002012 IL Practitioner - Optometry 4486872967 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

722 S Buffalo Grove Rd
Buffalo Grove, IL 60089-3708
Phone (847) 947-8875

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.010803ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Q Optique Inc Optometrist CurrentSince Dec 10, 2022 Accepting new patients
Perez Eye Care, Inc Optometrist CurrentSince Jun 19, 2014 Accepting new patients

Locations

722 Buffalo Grove Rd
Buffalo Grove, IL 60089
Phone (847) 947-8875

1855 W Taylor St
Rm 1075
Chicago, IL 60612

2252 W Cermak Rd
Chicago, IL 60608
Phone (773) 847-1581

25 E Washington St
Ste 820
Chicago, IL 60602
Phone (312) 332-0921

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": "1402531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1538573159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 E WASHINGTON ST",
            "address_2": "SUITE 820",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021708",
            "telephone_number": "312-848-4604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E WASHINGTON ST",
            "address_2": "SUITE 820",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021708",
            "telephone_number": "312-848-4604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "EMILY",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-12",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.010803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046010803",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.