Organization Active NPI

Eye Boutique, LLC

  • Optometrist
  • Joliet, IL
National Provider Identifier
1720236805
Registry record updated Mar 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
EYE BOUTIQUE, LLC
Practice address
2239 W. Jefferson Street
Joliet, IL 60435-6303
Phone
(815) 729-3752
Fax
(262) 923-7671
NPI assigned
Sep 3, 2008
Last updated
Mar 2, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
LUXOTTICA OF AMERICA INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 2, 2026

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

Authorized official

Name
Mr. Darren Thomas Horndasch
Title
President
Phone
(262) 432-2005

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X Primary

Addresses

Primary practice location

2239 W. Jefferson Street
Joliet, IL 60435-6303

Mailing address

16800 W Cleveland Ave
New Berlin, WI 53151-3533
Phone (262) 432-2005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090304000089 IL Part B Supplier - Clinic/Group Practice 7012073851 Receives reassigned benefits from 6 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Schaumburg, IL; Naperville, IL; Joliet, IL; Geneva, IL; Crystal Lake, IL; Algonquin, IL

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
David Cavender OD

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2239 W Jefferson St
Joliet, IL 60435
Phone (815) 729-3752

Practitioners & affiliated clinicians

Practitioners 4

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": "1220400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772409600000",
    "number": "1720236805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16800 W CLEVELAND AVE",
            "city": "NEW BERLIN",
            "state": "WI",
            "postal_code": "531513533",
            "telephone_number": "262-432-2005",
            "fax_number": "262-432-2006"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2239 W. JEFFERSON STREET",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356303",
            "telephone_number": "815-729-3752",
            "fax_number": "262-923-7671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EYE BOUTIQUE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LUXOTTICA OF AMERICA INC",
        "enumeration_date": "2008-09-03",
        "last_updated": "2026-03-02",
        "certification_date": "2026-03-02",
        "status": "A",
        "authorized_official_last_name": "HORNDASCH",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "262-432-2005",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; 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.