Individual provider Active NPI

Jennifer Ann Pawlak, O.D.

  • Optometrist
  • Algonquin, IL
National Provider Identifier
1588799704
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
245 Stonegate Rd
Algonquin, IL 60102-5614
Phone
(847) 658-0120
NPI assigned
Feb 21, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X IL Primary

Addresses

Primary practice location

245 Stonegate Rd
Algonquin, IL 60102-5614

Mailing address

10905 Sawgrass LN
Huntley, IL 60142-4048
Phone (847) 515-7882

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
I20120329000519 IL Practitioner - Optometry 4880854710 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Diana F Penuela-Oneill PCGroup PAC ID 4183807761, 3 clinicians

Practice addresses (Care Compare)

245 Stonegate Rd
Algonquin, IL 60102-5614
Phone (847) 658-0120

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-009010ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Diana F Penuela-Oneill PC Optometrist CurrentSince Mar 19, 2012 Accepting new patients

Locations

245 Stonegate Rd
Algonquin, IL 60102
Phone (847) 658-0120

Organizations & group practices 1

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": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588799704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10905 SAWGRASS LN",
            "city": "HUNTLEY",
            "state": "IL",
            "postal_code": "601424048",
            "telephone_number": "847-515-7882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 STONEGATE RD",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601025614",
            "telephone_number": "847-658-0120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAWLAK",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Algonquin, IL

Sources for this page

Verify at the official NPI Registry.