Individual provider Active NPI

Eirit Yonatan, OD

  • Optometrist
  • Mount Prospect, IL
National Provider Identifier
1659459857
Registry record updated Apr 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
1717 W Golf Rd
Mt Prospect, IL 60056
Phone
(847) 937-1414
Fax
(847) 437-9763
NPI assigned
Nov 2, 2006
Last updated
Apr 1, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2008

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

1717 W Golf Rd
Mt Prospect, IL 60056

Mailing address

1250 Ferndale Ave
Highland Park, IL 60035
Phone (847) 579-0880

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20191209000506 CO Practitioner - Optometry 6406842350 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009305ILMDOptometrist
OPT.0002960COMDPediatric Optometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Shawn Cottrell O.D., P.C. Optometrist CurrentSince Oct 31, 2019 Accepting new patients
Robert J S Mack, MD PC PastSince Nov 7, 2016 Accepting new patients
The Eye Site of Illinois, LLC Optometrist PastSince Dec 10, 2003 Accepting new patients

Locations

7913 Allison Way
Ste 102
Arvada, CO 80005
Phone (303) 424-5282

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": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1659459857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 FERNDALE AVE",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "60035",
            "telephone_number": "847-579-0880",
            "fax_number": "847-831-3652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 W GOLF RD",
            "city": "MT PROSPECT",
            "state": "IL",
            "postal_code": "60056",
            "telephone_number": "847-937-1414",
            "fax_number": "847-437-9763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YONATAN",
        "first_name": "EIRIT",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Prospect, IL

Sources for this page

Verify at the official NPI Registry.