Amanda Rose Ico, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

10423T Issued in TX

Practice address

6440 Main St Ste 100
Woodridge, IL 60517-1753

Phone

(630) 232-7800

NPI assigned

Sep 20, 2021

Last updated

Jul 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Seven Bridges Eye Care LLCGroup PAC ID 6901214709, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Seven Bridges Eye Care LLC

  dba Third Street Eyecare

  • Corneal and Contact Management Optometrist
  • Woodridge, IL
  • NPI 1124348917
  Medicare reassignment Care Compare group NPD
• Third Street Eyecare, LTD

  • Optometrist
  • Geneva, IL
  • NPI 1881971133
  NPD
• National Vision, Inc.

  dba America's Best Contacts & Eyeglasses

  • Optician
  • San Antonio, TX
  • NPI 1942667464
  NPD (past)

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719878400000",
    "number": "1558031666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "368 GLENWOOD DR APT 304",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601083263",
            "telephone_number": "630-632-1208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6440 MAIN ST STE 100",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "605171753",
            "telephone_number": "630-232-7800"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "500 S 3rd St Ste 105",
            "address_purpose": "LOCATION",
            "city": "Geneva",
            "state": "IL",
            "postal_code": "601342763",
            "country_code": "US",
            "telephone_number": "630-232-7800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ICO",
        "first_name": "AMANDA",
        "middle_name": "ROSE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-20",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "10423T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hyde & Speak PLLC
• Michelle Hyde
• Amy Beth Iacch, RN
• Julianne Marie Iandoli, PA-C
• Mark Ron Ibe Sr., MSN, APRN, FNP-C
• Illini Surgical Associates, Inc
• Illinois Bone and Joint Institute LLC
• Illinois Bone and Joint Institute, LLC
• Immediate Pain Care of Woodridge LLC
• Sylvia Irizarry, MD

• Optometrist in Woodridge, IL
• Providers in Woodridge, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.