Individual provider Active NPI

Erika Kristine Cleland, OD

  • Optometrist
  • Crystal Lake, IL
National Provider Identifier
1740577956
Registry record updated Aug 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010464 Issued in IL
Practice address
1 N Virginia St
Crystal Lake, IL 60014-4157
Phone
(815) 455-9393
NPI assigned
Jul 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010464 IL Primary

Addresses

Primary practice location

1 N Virginia St
Crystal Lake, IL 60014-4157

Mailing address

1 N Virginia St
Crystal Lake, IL 60014-4157
Phone (815) 455-9393

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111025000752 IL Practitioner - Optometry 7214100957 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Christina J. Levi O D P C.Group PAC ID 9436210762, 63 clinicians

Practice addresses (Care Compare)

1 N Virginia St
Crystal Lake, IL 60014-4157
Phone (815) 455-9393

2100 Troy Rd
Edwardsville, IL 62025-2595
Phone (618) 656-8888

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046010464ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Horner Eye Care LTD Optometrist CurrentSince Jan 1, 2022 Accepting new patients
Christina J. Levi O D P C Optometrist CurrentSince Jul 19, 2021 Accepting new patients
Christina J. Levi O D P C Optometrist Past Accepting new patients

Locations

111 E 4th St
Ste 440
Alton, IL 62002

211 E Broadway
Alton, IL 62002
Phone (314) 787-0681

1 N Virginia St
Crystal Lake, IL 60014
Phone (815) 455-9393

2100 Troy Rd
Edwardsville, IL 62025
Phone (618) 656-8888

10016 N Main St
Richmond, IL 60071
Phone (815) 678-3937

1603 N Alpine Rd
Ste 121
Rockford, IL 61107
Phone (815) 397-5959

Organizations & group practices 3

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": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409011200000",
    "number": "1740577956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 N VIRGINIA ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600144157",
            "telephone_number": "815-455-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 N VIRGINIA ST",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600144157",
            "telephone_number": "815-455-9393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLELAND",
        "first_name": "ERIKA",
        "middle_name": "KRISTINE",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2014-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crystal Lake, IL

Sources for this page

Verify at the official NPI Registry.