Individual provider Active NPI

Scott Hansen, OD

  • Optometrist
  • Tinley Park, IL
National Provider Identifier
1689244907
Registry record updated Dec 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.011531 Issued in IL
Practice address
9501 171St St Ste C
Tinley Park, IL 60487-6111
Phone
(708) 403-8300
Fax
(708) 403-8333
NPI assigned
Jun 29, 2021
Last updated
Dec 11, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.011531 IL Primary

Addresses

Primary practice location

9501 171St St Ste C
Tinley Park, IL 60487-6111

Mailing address

9501 171St St Ste C
Tinley Park, IL 60487-6111
Phone (708) 403-8300

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
I20260611000334 IL Practitioner - Optometry 6002202306 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2021
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

111 E 4TH St
Suite 440
Alton, IL 62002-6206

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.011531ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Insight Family Vision Care,Inc. Optometrist CurrentSince Dec 14, 2025 Accepting new patients
Fisher-Swale-Nicholson Eye Center SC Optometrist PastSince Dec 14, 2025 Accepting new patients

Locations

9501 171st St
Ste C
Tinley Park, IL 60487
Phone (708) 403-8300

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": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1689244907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9501 171ST ST STE C",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604876111",
            "telephone_number": "708-403-8300",
            "fax_number": "708-403-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9501 171ST ST STE C",
            "city": "TINLEY PARK",
            "state": "IL",
            "postal_code": "604876111",
            "telephone_number": "708-403-8300",
            "fax_number": "708-403-8333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "SCOTT",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-29",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tinley Park, IL

Sources for this page

Verify at the official NPI Registry.