Kevin Michael Pfeiffer, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046.011115 Issued in IL

Practice address

2914 Central St FL 1
Evanston, IL 60201-1237

Phone

(847) 864-4768

NPI assigned

Jun 15, 2017

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Southport Eye Associates LTD

  • Optometrist
  • Chicago, IL
  • NPI 1639302383
  NPD (past)

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

{
    "created_epoch": "1497484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497484800000",
    "number": "1629508270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41W105 OAK HILLS CT",
            "city": "ELBURN",
            "state": "IL",
            "postal_code": "601198869",
            "telephone_number": "217-799-5599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2914 CENTRAL ST FL 1",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602011237",
            "telephone_number": "847-864-4768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFEIFFER",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-15",
        "last_updated": "2017-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lance R Peterson, M.D.
• Timothy Peterson, MD
• Kyle Petty, MD
• Amanda L Pfeiffer, PA-C
• Kelly Jo Pfeiffer, PA-C
• Kristina Violet Pfeiffer, MD
• Hai Pham, APN-CRNA
• Hillary Pham, PT, DPT
• Ngan Tran Khanh Pham, MD
• Van D Pham, O.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2017; 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.