Individual provider Active NPI

Drew Klein, O.D.

  • Optometrist
  • Bloomington, IL
National Provider Identifier
1710039003
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046007201 Issued in IL
Practice address
2225 W. Market St.
Vision Center
Bloomington, IL 61705-5104
Phone
(309) 829-0636
Fax
(309) 829-0977
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046007201 IL Primary

Addresses

Primary practice location

2225 W. Market St.
Vision Center
Bloomington, IL 61705-5104

Mailing address

2225 W. Market St.
Vision Center
Bloomington, IL 61705-5104
Phone (847) 962-1877

Other practice location 1

1200 E 53rd St
Chicago, IL 60615-4008
Phone (773) 493-8372

Other practice location 2

1200 E 53rd St
Chicago, IL 60615-4008
Phone (773) 493-8372

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ami Patel OD Inc Optometrist PastSince Jul 27, 2014 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1710039003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 W. MARKET ST.",
            "address_2": "VISION CENTER",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617055104",
            "telephone_number": "847-962-1877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 W. MARKET ST.",
            "address_2": "VISION CENTER",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617055104",
            "telephone_number": "309-829-0636",
            "fax_number": "309-829-0977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1200 E 53rd St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606154008",
            "country_code": "US",
            "telephone_number": "773-493-8372",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1200 E 53rd St",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606154008",
            "country_code": "US",
            "telephone_number": "773-493-8372",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "DREW",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046007201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.