Active NPI
Ronald E St. Juliana, O.D.
- Optometrist
- Downers Grove, IL
National Provider Identifier
1740418656
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046006575
- Practice address
- 1402 Butterfield Rd
Butterfield Plaza
Downers Grove, IL 60515-1031 - Phone
- (630) 520-0049
- NPI assigned
- Jun 30, 2009
- Sex
- Male
- Sole proprietor
- No
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 | 046006575 | IL | Primary |
Addresses
Primary practice location
1402 Butterfield Rd
Butterfield Plaza
Downers Grove, IL 60515-1031
Mailing address
30 W 075 Willow Lane
Warrenville, IL 60555
Phone (630) 520-0049
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 |
|---|---|---|---|
| 046006575 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Family Eye Care Center of Burbank, LTD | Optometrist | 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 and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1246320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1246320000000",
"number": "1740418656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "30 W 075 WILLOW LANE",
"city": "WARRENVILLE",
"state": "IL",
"postal_code": "60555",
"telephone_number": "630-520-0049"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1402 BUTTERFIELD RD",
"address_2": "BUTTERFIELD PLAZA",
"city": "DOWNERS GROVE",
"state": "IL",
"postal_code": "605151031",
"telephone_number": "630-520-0049"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ST. JULIANA",
"first_name": "RONALD",
"middle_name": "E",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-06-30",
"last_updated": "2009-06-30",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046006575",
"primary": true
}
],
"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 Jun 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.