Individual provider Active NPI

Lisa A Dryier, OD

  • Optometrist
  • Bolingbrook, IL
National Provider Identifier
1659457448
Registry record updated Feb 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009236 Issued in IL
Practice address
623 E Boughton Rd Ste 120
Bolingbrook, IL 60440-2694
Phone
(630) 783-1514
NPI assigned
Oct 27, 2006
Last updated
Feb 26, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009236 IL Primary

Addresses

Primary practice location

623 E Boughton Rd Ste 120
Bolingbrook, IL 60440-2694

Mailing address

623 E Boughton Rd Ste 120
Bolingbrook, IL 60440-2694
Phone (630) 783-1514

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
I20040813001191 IL Practitioner - Optometry 7214900604 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009236ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Visionworks, Inc CurrentSince Sep 1, 2019 Accepting new patients
Visionworks, Inc. Optometrist CurrentSince Sep 1, 2019 Accepting new patients
Special Eyes Optometrist Past Accepting new patients

Locations

623 E Boughton Rd
Ste 120
Bolingbrook, IL 60440
Phone (630) 783-1514

239 Golf Mill Ctr
Ste 255
Niles, IL 60714
Phone (847) 297-2286

2422 US Highway 34
Oswego, IL 60543
Phone (630) 551-4133

19100 Ridgewood Pkwy
Bldg 1
San Antonio, TX 78259
Phone (726) 444-4069

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": "1161907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330214400000",
    "number": "1659457448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 E BOUGHTON RD STE 120",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402694",
            "telephone_number": "630-783-1514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 E BOUGHTON RD STE 120",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604402694",
            "telephone_number": "630-783-1514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRYIER",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Mrs.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-27",
        "last_updated": "2012-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bolingbrook, IL

Sources for this page

Verify at the official NPI Registry.