Organization Active NPI

Dupage Optical, Inc.

  • Optometrist
  • Addison, IL
National Provider Identifier
1710010608
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
DUPAGE OPTICAL, INC.
Practice address
207 S Addison Rd
Addison, IL 60101-3809
Phone
(630) 279-8866
Fax
(630) 279-2609
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Authorized official

Name
Dr. Steven P. Butzon, O.D.
Title
Owner
Phone
(630) 279-8866

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X IL Primary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X IL
Corneal and Contact Management OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WC0802X IL
Vision Therapy OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WV0400X IL
Occupational Vision OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152WX0102X IL

Addresses

Primary practice location

207 S Addison Rd
Addison, IL 60101-3809

Mailing address

207 S Addison Rd
Addison, IL 60101-3809
Phone (630) 279-8866

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080325000325 IL Part B Supplier - Clinic/Group Practice 1557447083 Receives reassigned benefits from 3 practitioners
Practice locations: Addison, IL

National Provider Directory

National Provider Directory

Locations

207 S Addison Rd
Addison, IL 60101
Phone (630) 279-8866

619 W North Ave
Villa Park, IL 60181
Phone (630) 279-8866

311 N Walnut Ave
Ste 120
Wood Dale, IL 60191
Phone (630) 766-3763

Practitioners & affiliated clinicians

Practitioners 3

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": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1710010608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "207 S ADDISON RD",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601013809",
            "telephone_number": "630-279-8866",
            "fax_number": "630-279-2609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 S ADDISON RD",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601013809",
            "telephone_number": "630-279-8866",
            "fax_number": "630-279-2609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUPAGE OPTICAL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "BUTZON",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-279-8866",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "152WC0802X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "152WV0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Vision Therapy",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "152WX0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist, Occupational Vision",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.