Individual provider Active NPI

Brian Oswald, O.D.

  • Optometrist
  • Crestwood, IL
National Provider Identifier
1659462158
Registry record updated Apr 26, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046007495 Issued in IL
Practice address
5553 127TH St
Crestwood, IL 60445-1123
Phone
(708) 371-5160
Fax
(708) 930-1844
NPI assigned
Sep 27, 2006
Last updated
Apr 26, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046007495 IL Primary

Addresses

Primary practice location

5553 127TH St
Crestwood, IL 60445-1123

Mailing address

5553 127TH St
Crestwood, IL 60445-1123
Phone (708) 371-5160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046007495ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Absolute Vision Care LTD Optometrist PastSince Dec 29, 1992 Accepting new patients
Absolute Vision Care III, Inc. Optometrist PastSince Apr 30, 2003 Accepting new patients

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, 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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1272240000000",
    "number": "1659462158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5553 127TH ST",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604451123",
            "telephone_number": "708-371-5160",
            "fax_number": "708-930-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5553 127TH ST",
            "city": "CRESTWOOD",
            "state": "IL",
            "postal_code": "604451123",
            "telephone_number": "708-371-5160",
            "fax_number": "708-930-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSWALD",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2010-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestwood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.