Jenelle L Mallios Gialousakis, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046011190 Issued in IL

Practice address

3450 Lacey Rd
Downers Grove, IL 60515-5430

Phone

(630) 743-4500

Fax

(630) 743-4537

NPI assigned

Aug 4, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

New England College of Optometry, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Midwestern UniversityGroup PAC ID 6305734773, 116 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jenelle.mallios.p1@direct.midwesternuniversity.nextgenshare.com
• Direct secure messaging: jmalliosgialousakis18719@direct.midwestern.edu

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.

• Midwestern University

  • Clinic/Center
  • Downers Grove, IL
  • NPI 1538445317
  Medicare reassignment Care Compare group NPD
• Midwestern University

  • Optometrist
  • Downers Grove, IL
  • NPI 1295126324
  NPD
• Midwestern University

  • Multi-Specialty Clinic/Center
  • Glendale, AZ
  • NPI 1932206414

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1280880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542326400000",
    "number": "1700190535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 LACEY RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155430",
            "telephone_number": "630-743-4500",
            "fax_number": "630-743-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 LACEY RD",
            "city": "DOWNERS GROVE",
            "state": "IL",
            "postal_code": "605155430",
            "telephone_number": "630-743-4500",
            "fax_number": "630-743-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLIOS GIALOUSAKIS",
        "first_name": "JENELLE",
        "middle_name": "L",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-04",
        "last_updated": "2018-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Patricia Maletich
• Rabindra Nath Malhotra, M.D.
• Owais M Malick, MD
• Sarah Caitlin Malinowski, LPC
• Adam John Mallinger, D.O.
• Erica Malloy
• Marsha Maloloyon
• Grace Nelson Maloney
• Stavros Nicholas Maltezos, M.D.
• Claire Maly

• Optometrist in Downers Grove, IL
• Providers in Downers Grove, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.