Active NPI
Peter Jay Epstein, OD.
- Optometrist
- Vernon Hills, IL
National Provider Identifier
1730256470
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046-006615
- Practice address
- 335 N Milwaukee Ave
Vernon Hills, IL 60061-1561 - Phone
- (847) 955-9280
- Fax
- (847) 955-9282
- NPI assigned
- Nov 29, 2006
- Last updated
- Apr 15, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046-006615 | IL | Primary |
Addresses
Primary practice location
335 N Milwaukee Ave
Vernon Hills, IL 60061-1561
Mailing address
5248 RFD
Long Grove, IL 60047-7353
Phone (847) 521-0771
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 046006615 | Medicaid | IL |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046-006615 | IL | MD | Optometrist |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Vernon Hills, IL
- NPI 1841432010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1429056000000",
"number": "1730256470",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5248 RFD",
"city": "LONG GROVE",
"state": "IL",
"postal_code": "600477353",
"telephone_number": "847-521-0771",
"fax_number": "847-955-9282"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "335 N MILWAUKEE AVE",
"city": "VERNON HILLS",
"state": "IL",
"postal_code": "600611561",
"telephone_number": "847-955-9280",
"fax_number": "847-955-9282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EPSTEIN",
"first_name": "PETER",
"middle_name": "JAY",
"name_prefix": "Dr.",
"credential": "OD.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-29",
"last_updated": "2015-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046-006615",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "046006615",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vernon Hills, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.