Active NPI
Mary Lou French, O.D.
- Pediatric Optometrist
- Downers Grove, IL
National Provider Identifier
1740263573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Optometrist
- License
- 46-6963
- Practice address
- 3450 Lacey Rd
Downers Grove, IL 60515-5430 - Phone
- (630) 743-4500
- NPI assigned
- Nov 25, 2005
- Last updated
- Jan 3, 2017
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Optometrist | 152WP0200X | 46-6963 | IL | Primary |
| Vision Therapy Optometrist | 152WV0400X | 466963 | IL |
Addresses
Primary practice location
3450 Lacey Rd
Downers Grove, IL 60515-5430
Mailing address
3450 Lacey Rd
Downers Grove, IL 60515-5430
Phone (630) 743-4500
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 |
|---|---|---|---|
| 46-6963 | IL | MD | Pediatric Optometrist |
| 466963 | IL | MD | Vision Therapy Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vision Source, P.C. | Pediatrics | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1483401600000",
"number": "1740263573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3450 LACEY RD",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605155430",
"telephone_number": "630-743-4500",
"fax_number": "630-743-4537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3450 LACEY RD",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605155430",
"telephone_number": "630-743-4500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRENCH",
"first_name": "MARY LOU",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-11-25",
"last_updated": "2017-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "152WP0200X",
"taxonomy_group": "",
"desc": "Optometrist, Pediatrics",
"state": "IL",
"license": "46-6963",
"primary": true
},
{
"code": "152WV0400X",
"taxonomy_group": "",
"desc": "Optometrist, Vision Therapy",
"state": "IL",
"license": "466963",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Downers Grove, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.