Active NPI
Donna Li
- Optometrist
- Berwyn, IL
National Provider Identifier
1629806914
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046.011881
- Practice address
- 7153 Cermak Rd
Berwyn, IL 60402-2103 - Phone
- (708) 795-8585
- NPI assigned
- Jul 26, 2024
- Last updated
- Jul 26, 2024
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046.011881 | IL | Primary |
Addresses
Primary practice location
7153 Cermak Rd
Berwyn, IL 60402-2103
Mailing address
3343 W 38TH St
Chicago, IL 60632-2714
Phone (312) 493-2512
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
3343 W 38TH St
Chicago, IL 60632-2714
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046.011881 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc. | Past | Accepting new patients | |
| Luxottica of America Inc | Past | Accepting new patients |
Organizations & group practices 3
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": "1721952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721952000000",
"number": "1629806914",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3343 W 38TH ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606322714",
"telephone_number": "312-493-2512"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7153 CERMAK RD",
"city": "BERWYN",
"state": "IL",
"postal_code": "604022103",
"telephone_number": "708-795-8585"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LI",
"first_name": "DONNA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-26",
"last_updated": "2024-07-26",
"certification_date": "2024-06-17",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046.011881",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Berwyn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 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.