NPIMap

Organization Active NPI

Myeyedr Optometry of Illinois, LLC

  • Optometrist
  • Lombard, IL
National Provider Identifier
1649039751
Registry record updated Mar 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
MYEYEDR OPTOMETRY OF ILLINOIS, LLC
Practice address
837 Westmore Meyers Rd Ste A24
Lombard, IL 60148-6516
Phone
(630) 474-4487
Fax
(630) 487-5109
NPI assigned
Mar 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2024

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

Authorized official

Name
Sue Downes
Title
Secretary
Phone
(703) 847-8899

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

837 Westmore Meyers Rd Ste A24
Lombard, IL 60148-6516

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

Other names 1

  • MyEyeDr. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160310001870 IL Part B Supplier - Clinic/Group Practice 3577869965 Receives reassigned benefits from 113 practitioners
This NPI is an additional NPI on the enrollment

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2264957Myeyedr Optometry of Illinois, LLC837 S Westmore-Meyers Rd - Ste A24, Lombard, IL 60148Certificate of waiverJul 20, 2028

National Provider Directory

National Provider Directory
Tax ID family
Myeyedr38 organizations share this tax ID, including this one

Other organizations with this tax ID 37

Organizations that report the same tax identification number in the National Provider Directory.

View all 37

Locations

837 Westmore Meyers Rd
Ste A24
Lombard, IL 60148
Phone (630) 474-4487

NPI Registry JSON

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1649039751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "837 WESTMORE MEYERS RD STE A24",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601486516",
            "telephone_number": "630-474-4487",
            "fax_number": "630-487-5109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYEYEDR OPTOMETRY OF ILLINOIS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "DOWNES",
        "authorized_official_first_name": "SUE",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "703-847-8899"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MyEyeDr.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lombard, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.