Organization Active NPI

Opt Vision

Doing business as Opt Vision Studio

  • Optometrist
  • Chicago, IL
National Provider Identifier
1538778097
Registry record updated Jul 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
OPT VISION
Doing business as
Opt Vision Studio
Practice address
5371 W Lawrence Ave Ste a
Chicago, IL 60630-3695
Phone
(847) 890-3172
NPI assigned
Jul 30, 2020
Last updated
Jul 30, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2020

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

Authorized official

Name
Dr. Gabrielle Monica Szwajca, ODNPI 1316396179
Title
President
Phone
(847) 890-3172

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
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

5371 W Lawrence Ave Ste a
Chicago, IL 60630-3695

Mailing address

111 S Peoria St Unit 307
Chicago, IL 60607-2883
Phone (847) 890-3172

Other names 1

  • Opt Vision Studio Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200819003739 IL Part B Supplier - Clinic/Group Practice 8820414907 Receives reassigned benefits from 2 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

5371 W Lawrence Ave
Ste A
Chicago, IL 60630
Phone (847) 890-3172

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1596067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1596067200000",
    "number": "1538778097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S PEORIA ST UNIT 307",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606072883",
            "telephone_number": "847-890-3172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5371 W LAWRENCE AVE STE A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606303695",
            "telephone_number": "847-890-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPT VISION",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-30",
        "last_updated": "2020-07-30",
        "certification_date": "2020-07-30",
        "status": "A",
        "authorized_official_last_name": "SZWAJCA",
        "authorized_official_first_name": "GABRIELLE",
        "authorized_official_middle_name": "MONICA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-890-3172",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Opt Vision Studio",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; 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.