Organization Active NPI

Vista Linda Eye Care Inc

  • Optometrist
  • Mount Prospect, IL
National Provider Identifier
1619255254
Registry record updated Nov 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
VISTA LINDA EYE CARE INC
Practice address
111 W Prospect Ave
Mt Prospect, IL 60056-3135
Phone
(847) 253-2100
Fax
(847) 253-2111
NPI assigned
Aug 1, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2011

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

Authorized official

Name
Dr. Linda S Murray, O.D.NPI 1851424006
Title
Owner
Phone
(847) 253-2100

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
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X IL Primary

Addresses

Primary practice location

111 W Prospect Ave
Mt Prospect, IL 60056-3135

Mailing address

111 W Prospect Ave
Mt Prospect, IL 60056-3135
Phone (847) 253-2100

Other identifiers 1

IdentifierTypeStateIssuer
1851424006MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110901000326 IL Part B Supplier - Clinic/Group Practice 7315117298 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Prospect, IL

National Provider Directory

National Provider Directory

Locations

111 W Prospect Ave
Mt Prospect, IL 60056
Phone (847) 253-2100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1312156800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321488000000",
    "number": "1619255254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 W PROSPECT AVE",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600563135",
            "telephone_number": "847-253-2100",
            "fax_number": "847-253-2111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W PROSPECT AVE",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "600563135",
            "telephone_number": "847-253-2100",
            "fax_number": "847-253-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA LINDA EYE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-01",
        "last_updated": "2011-11-17",
        "status": "A",
        "authorized_official_last_name": "MURRAY",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-253-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1851424006",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Prospect, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2011; 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.