NPIMap

Organization Active NPI

Donald V Maduzia O.D. P.C.

  • Optometrist
  • Clarendon Hills, IL
National Provider Identifier
1700052834
Registry record updated Oct 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.007789 Issued in IL
Legal business name
DONALD V MADUZIA O.D. P.C.
Practice address
203 Railroad Avenue
Clarendon Hills, IL 60514
Phone
(630) 323-3202
Fax
(630) 321-0512
NPI assigned
May 8, 2008
Last updated
Oct 27, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2008

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

Authorized official

Name
Dr. Donald V Maduzia, O.D.NPI 1518049626
Title
Optomotrist
Phone
(630) 323-3202

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.007789 IL Primary

Addresses

Primary practice location

203 Railroad Avenue
Clarendon Hills, IL 60514

Mailing address

203 Railroad Avenue
Clarendon Hills, IL 60514
Phone (630) 323-3202

Other identifiers 3

IdentifierTypeStateIssuer
2284078OtherBCBS
2284078OtherILBC/BS
4123680001OtherDURABLE GOODS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1210204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1225065600000",
    "number": "1700052834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 RAILROAD AVENUE",
            "city": "CLARENDON HILLS",
            "state": "IL",
            "postal_code": "60514",
            "telephone_number": "630-323-3202",
            "fax_number": "630-321-0512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 RAILROAD AVENUE",
            "city": "CLARENDON HILLS",
            "state": "IL",
            "postal_code": "60514",
            "telephone_number": "630-323-3202",
            "fax_number": "630-321-0512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DONALD V MADUZIA O.D. P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-08",
        "last_updated": "2008-10-27",
        "status": "A",
        "authorized_official_last_name": "MADUZIA",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "OPTOMOTRIST",
        "authorized_official_telephone_number": "630-323-3202",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.007789",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "2284078",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "2284078",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DURABLE GOODS",
            "identifier": "4123680001",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarendon Hills, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2008; 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.