NPIMap

Organization Active NPI

Wheaton Eye Clinic LTD

  • Ophthalmology Physician
  • Bartlett, IL
National Provider Identifier
1558086652
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
WHEATON EYE CLINIC LTD
Practice address
980 S Il Route 59
Bartlett, IL 60103-1668
Phone
(630) 668-8250
Fax
(630) 668-8916
NPI assigned
Oct 11, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Authorized official

Name
Lisa White
Title
Credentialing Specialist
Phone
(630) 588-3630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X Primary

Addresses

Primary practice location

980 S Il Route 59
Bartlett, IL 60103-1668

Mailing address

2015 N Main St
Wheaton, IL 60187-3190
Phone (630) 668-8250

Other names 1

  • Wheaton Eye Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Benjamin H Ticho MD4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1665446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1558086652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 N MAIN ST",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873190",
            "telephone_number": "630-668-8250",
            "fax_number": "630-668-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 S IL ROUTE 59",
            "city": "BARTLETT",
            "state": "IL",
            "postal_code": "601031668",
            "telephone_number": "630-668-8250",
            "fax_number": "630-668-8916"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHEATON EYE CLINIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-11",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "630-588-3630"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wheaton Eye Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bartlett, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.