Individual provider Active NPI

Christian James Miklos, OD

  • Optometrist
  • Joliet, IL
National Provider Identifier
1548158918
Registry record updated Jun 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.011975 Issued in IL
Practice address
3340 Mall Loop Dr SPC 1532
Joliet, IL 60431-1168
Phone
(815) 436-1770
Fax
(815) 436-1803
NPI assigned
Jun 25, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.011975 IL Primary

Addresses

Primary practice location

3340 Mall Loop Dr SPC 1532
Joliet, IL 60431-1168

Mailing address

1311 Acorn St
Lemont, IL 60439-6431
Phone (630) 605-8544

Other practice location 1

641 E Boughton Rd Ste 105
Bolingbrook, IL 60440-3145
Phone (630) 783-0138

Other practice location 2

864 Orland Square Dr
Orland Park, IL 60462-3223
Phone (708) 403-3060

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
I20260603000406 IL Practitioner - Optometry 3274004015 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2025
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1311 Acorn St
Lemont, IL 60439-6431

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.011975ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Luxottica of America Inc. PastSince Nov 10, 2019 Accepting new patients
Luxottica of America Inc Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1750809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750809600000",
    "number": "1548158918",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 ACORN ST",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604396431",
            "telephone_number": "630-605-8544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3340 MALL LOOP DR SPC 1532",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604311168",
            "telephone_number": "815-436-1770",
            "fax_number": "815-436-1803"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "641 E Boughton Rd Ste 105",
            "address_purpose": "LOCATION",
            "city": "Bolingbrook",
            "state": "IL",
            "postal_code": "604403145",
            "country_code": "US",
            "telephone_number": "630-783-0138",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "864 Orland Square Dr",
            "address_purpose": "LOCATION",
            "city": "Orland Park",
            "state": "IL",
            "postal_code": "604623223",
            "country_code": "US",
            "telephone_number": "708-403-3060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MIKLOS",
        "first_name": "CHRISTIAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-06-25",
        "last_updated": "2025-06-25",
        "certification_date": "2025-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

Verify at the official NPI Registry.