Individual provider Active NPI

James Carroll, OD

  • Optometrist
  • Oak Lawn, IL
National Provider Identifier
1649018391
Registry record updated Jan 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011892 Issued in IL
Practice address
6201 W 95TH St
Oak Lawn, IL 60453-2701
Phone
(708) 636-9393
Fax
(708) 636-2022
NPI assigned
Jul 17, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Optometrist 152W00000X 046011892 IL Primary

Addresses

Primary practice location

6201 W 95TH St
Oak Lawn, IL 60453-2701

Mailing address

1405 Walnut Ave
Mendota, IL 61342-9005
Phone (815) 910-5570

Other practice location 1

4459 N Kedzie Ave
Chicago, IL 60625-4785
Phone (773) 866-2020

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
I20241214000219 IL Practitioner - Optometry 7012443914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Eye Physicians LTDGroup PAC ID 5799743670, 17 clinicians

Practice addresses (Care Compare)

4459 N Kedzie Ave
Chicago, IL 60625-4785
Phone (773) 866-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046011892ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Family Eye Physicians, LTD Optometrist CurrentSince Sep 24, 2024 Accepting new patients
20/20 Eye Physicians of Indiana P C PastSince Jul 1, 2024 Accepting new patients

Locations

68 W Dundee Rd
Buffalo Grove, IL 60089
Phone (708) 636-9393

6201 W 95th St
Oak Lawn, IL 60453
Phone (708) 636-5615

17W682 Butterfield Rd
Ste 101
Oakbrook Terrace, IL 60181
Phone (708) 636-9393

14494 John Humphrey Dr
Orland Park, IL 60462
Phone (708) 226-9393

1760 W Wise Rd
Schaumburg, IL 60193
Phone (708) 636-9393

Organizations & group practices 2

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": "1721174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1767657600000",
    "number": "1649018391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 WALNUT AVE",
            "city": "MENDOTA",
            "state": "IL",
            "postal_code": "613429005",
            "telephone_number": "815-910-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6201 W 95TH ST",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532701",
            "telephone_number": "708-636-9393",
            "fax_number": "708-636-2022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4459 N Kedzie Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606254785",
            "country_code": "US",
            "telephone_number": "773-866-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARROLL",
        "first_name": "JAMES",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-17",
        "last_updated": "2026-01-06",
        "certification_date": "2026-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.