NPIMap

Organization Active NPI

Tennenbaum and Anstadt, LTD

Doing business as Gottlieb Eye Center

  • Eyewear Supplier
  • Melrose Park, IL
National Provider Identifier
1740530971
Registry record updated Jun 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Eyewear SupplierTaxonomy code 332H00000X
Legal business name
TENNENBAUM AND ANSTADT, LTD
Doing business as
Gottlieb Eye Center
Practice address
675 W North Ave
Ste 107
Melrose Park, IL 60160-1634
Phone
(708) 450-4510
NPI assigned
Sep 14, 2012
Last updated
Jun 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2020

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

Authorized official

Name
Jeneen Santucci
Title
Office Manager
Phone
(708) 450-4510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Eyewear Supplier 332H00000X Primary

Addresses

Primary practice location

675 W North Ave
Ste 107
Melrose Park, IL 60160-1634

Mailing address

675 W North Ave
Ste 107
Melrose Park, IL 60160-1634
Phone (708) 450-4510

Other names 1

  • Gottlieb Eye Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930009275 IL DME Supplier - Physician - Ophthalmology 7618985730 1 other NPI on this enrollment
Practice locations: Melrose Park, IL

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

7255 W Grand Ave
Ste 2
Elmwood Park, IL 60707
Phone (708) 452-5960

5201 Willow Springs Rd
Ste 450
La Grange Highlands, IL 60525
Phone (708) 354-2008

Practitioners & affiliated clinicians

Practitioners 10

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": "1347580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592784000000",
    "number": "1740530971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE",
            "address_2": "STE 107",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601634",
            "telephone_number": "708-450-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 W NORTH AVE",
            "address_2": "STE 107",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601601634",
            "telephone_number": "708-450-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TENNENBAUM AND ANSTADT, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-14",
        "last_updated": "2020-06-22",
        "certification_date": "2020-06-22",
        "status": "A",
        "authorized_official_last_name": "SANTUCCI",
        "authorized_official_first_name": "JENEEN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "708-450-4510"
    },
    "taxonomies": [
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Gottlieb Eye Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Melrose Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2020; 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.