Individual provider Active NPI

Kelly D. Laurenti, M.D.

  • Pediatric Ophthalmology and Strabismus Specialist Physician
  • Wheaton, IL
National Provider Identifier
1700129442
Registry record updated Feb 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Ophthalmology and Strabismus Specialist PhysicianTaxonomy code 207WX0110X
License
036.143113 Issued in IL
Practice address
2015 N Main St
Wheaton, IL 60187-3190
Phone
(630) 668-8250
Fax
(630) 668-8916
NPI assigned
Apr 1, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036.143113 IL
Pediatric Ophthalmology and Strabismus Specialist Physician 207WX0110X 036.143113 IL Primary

Addresses

Primary practice location

2015 N Main St
Wheaton, IL 60187-3190

Mailing address

2015 N Main St
Wheaton, IL 60187-3190
Phone (630) 668-8250

Other practice location 1

225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-6180

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180920003034 IL Practitioner - Pediatric MedicinePractitioner - Ophthalmology 5496048019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Ophthalmology
Education
St. Louis College of Physicians and Surgeons, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Wheaton Eye Clinic LTDGroup PAC ID 2860475944, 44 clinicians

Practice addresses (Care Compare)

2015 N Main St
Wheaton, IL 60187-3152
Phone (630) 668-8250

Hospital & facility affiliations

  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.143113ILMDPediatric Ophthalmology and Strabismus Specialist Physician Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wheaton Eye Clinic LTD Ophthalmology CurrentSince Mar 17, 2025 Accepting new patients
Wheaton Eye Clinic LTD Ophthalmology CurrentSince Mar 17, 2025 Accepting new patients
Gibson Community Hospital Association Ophthalmology Past Accepting new patients
Wheaton Eye Clinic LTD Ophthalmology Past Accepting new patients

Locations

908 N Elm St
Ste 115
Hinsdale, IL 60521
Phone (630) 668-8250

24024 Brancaster Dr
Naperville, IL 60564
Phone (630) 357-8700

12426 S Van Dyke Rd
Plainfield, IL 60585
Phone (630) 668-8250

2015 N Main St
Wheaton, IL 60187
Phone (630) 665-3690

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1364774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740614400000",
    "number": "1700129442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 N MAIN ST",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873190",
            "telephone_number": "630-668-8250",
            "fax_number": "630-668-8916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2015 N MAIN ST",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873190",
            "telephone_number": "630-668-8250",
            "fax_number": "630-668-8916"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 E Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60611",
            "country_code": "US",
            "telephone_number": "312-227-6180",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAURENTI",
        "first_name": "KELLY",
        "middle_name": "D.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-01",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036.143113",
            "primary": false
        },
        {
            "code": "207WX0110X",
            "taxonomy_group": "",
            "desc": "Ophthalmology, Pediatric Ophthalmology and Strabismus Specialist",
            "state": "IL",
            "license": "036.143113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheaton, IL

Sources for this page

Verify at the official NPI Registry.