Individual provider Active NPI

Leo Kammer, O.D.

  • Optometrist
  • Chicago Ridge, IL
National Provider Identifier
1639227499
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
320 Chicago Ridge Mall
Ste #C15
Chicago Ridge, IL 60415-2602
Phone
(708) 423-0033
NPI assigned
Jan 8, 2007
Sex
Male
Sole proprietor
No

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

320 Chicago Ridge Mall
Ste #C15
Chicago Ridge, IL 60415-2602

Mailing address

9859 Giles Dr
Mokena, IL 60448-7816
Phone (708) 479-4184

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
I20141215001944 IL Order and Referring Only - OptometryPractitioner - Optometry 7517003387

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-008294ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Luxottica of America Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639227499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9859 GILES DR",
            "city": "MOKENA",
            "state": "IL",
            "postal_code": "604487816",
            "telephone_number": "708-479-4184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 CHICAGO RIDGE MALL",
            "address_2": "STE #C15",
            "city": "CHICAGO RIDGE",
            "state": "IL",
            "postal_code": "604152602",
            "telephone_number": "708-423-0033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMMER",
        "first_name": "LEO",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-08",
        "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 Chicago Ridge, IL

Sources for this page

Verify at the official NPI Registry.