Organization Active NPI

D C Optics LTD

Doing business as Professional Eye Care

  • Optometrist
  • Wilmette, IL
National Provider Identifier
1669045464
Registry record updated Jul 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
D C OPTICS LTD
Doing business as
Professional Eye Care
Practice address
3223 Lake Ave Ste 14C
Wilmette, IL 60091-1069
Phone
(847) 256-8100
Fax
(847) 256-8102
NPI assigned
Jul 20, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2021

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

Authorized official

Name
Dr. James P Costello, ODNPI 1740386887
Title
Owner
Phone
(847) 256-8100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

3223 Lake Ave Ste 14C
Wilmette, IL 60091-1069

Mailing address

3223 Lake Ave Ste 14C
Wilmette, IL 60091-1069
Phone (847) 256-8100

Other names 1

  • PROFESSIONAL EYE CARE Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210818000736 IL Part B Supplier - Clinic/Group Practice 0547665317 Receives reassigned benefits from 1 practitioner
Practice locations: Wilmette, IL

National Provider Directory

National Provider Directory

Locations

3223 Lake Ave
Wilmette, IL 60091

3223 Lake Ave
Ste 14C
Wilmette, IL 60091
Phone (847) 256-8100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626739200000",
    "number": "1669045464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3223 LAKE AVE STE 14C",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911069",
            "telephone_number": "847-256-8100",
            "fax_number": "847-256-8102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 LAKE AVE STE 14C",
            "city": "WILMETTE",
            "state": "IL",
            "postal_code": "600911069",
            "telephone_number": "847-256-8100",
            "fax_number": "847-256-8102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "D C OPTICS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-20",
        "last_updated": "2021-07-20",
        "certification_date": "2021-07-20",
        "status": "A",
        "authorized_official_last_name": "COSTELLO",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-256-8100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PROFESSIONAL EYE CARE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmette, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.