NPIMap

Organization Active NPI

Six Corners Eye Care LLC

Doing business as Pearle Vision Six Corners

  • Optometrist
  • Chicago, IL
National Provider Identifier
1629899141
Registry record updated Jan 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
SIX CORNERS EYE CARE LLC
Doing business as
Pearle Vision Six Corners
Practice address
4017 N Milwaukee Ave
Chicago, IL 60641-1834
Phone
(773) 545-2660
NPI assigned
Oct 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2025

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

Authorized official

Name
Tajal Patel Darne, ODNPI 1306038583
Title
Owner
Phone
(832) 607-2055

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: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

4017 N Milwaukee Ave
Chicago, IL 60641-1834

Mailing address

2501 Chatham Rd Ste R
Springfield, IL 62704-4188
Phone (832) 607-2055

Other names 1

  • PEARLE VISION SIX CORNERS Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250121001550 IL Part B Supplier - Clinic/Group Practice 4587193594 Receives reassigned benefits from 9 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

4017 N Milwaukee Ave
Chicago, IL 60641
Phone (773) 545-2660

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736812800000",
    "number": "1629899141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CHATHAM RD STE R",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044188",
            "telephone_number": "832-607-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4017 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606411834",
            "telephone_number": "773-545-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIX CORNERS EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-17",
        "last_updated": "2025-01-14",
        "certification_date": "2025-01-14",
        "status": "A",
        "authorized_official_last_name": "PATEL DARNE",
        "authorized_official_first_name": "TAJAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-607-2055",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEARLE VISION SIX CORNERS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PEARLE VISION SIX CORNERS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2025; 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.