Organization Active NPI

Oswego Vision, LTD

  • Optometrist
  • Oswego, IL
National Provider Identifier
1740203850
Registry record updated Jan 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046008044 Issued in IL
Legal business name
OSWEGO VISION, LTD
Practice address
83 Templeton Dr
Suite F
Oswego, IL 60543-7019
Phone
(630) 554-8002
Fax
(630) 554-8095
NPI assigned
Jul 26, 2006
Last updated
Jan 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2009

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

Authorized official

Name
Alan E. Hein, OD
Title
Owner
Phone
(630) 554-8002

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046008044 IL Primary

Addresses

Primary practice location

83 Templeton Dr
Suite F
Oswego, IL 60543-7019

Mailing address

83 Templeton Dr
Suite F
Oswego, IL 60543-7019
Phone (630) 554-8002

Other identifiers 1

IdentifierTypeStateIssuer
4721437OtherILBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051110000396 IL Part B Supplier - Clinic/Group Practice 5496773103 Receives reassigned benefits from 3 practitioners
Practice locations: Oswego, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2324735Oswego Vision, LTD83 Templeton Dr - Ste F, Oswego, IL 60543Certificate of waiverMay 29, 2027

National Provider Directory

National Provider Directory

Locations

83 Templeton Dr
Oswego, IL 60543

Practitioners & affiliated clinicians

Practitioners 6

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": "1153872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232668800000",
    "number": "1740203850",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 TEMPLETON DR",
            "address_2": "SUITE F",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437019",
            "telephone_number": "630-554-8002",
            "fax_number": "630-554-8095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 TEMPLETON DR",
            "address_2": "SUITE F",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437019",
            "telephone_number": "630-554-8002",
            "fax_number": "630-554-8095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OSWEGO VISION, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-26",
        "last_updated": "2009-01-23",
        "status": "A",
        "authorized_official_last_name": "HEIN",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-554-8002",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4721437",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.