Active NPI
Jennifer Cameron, OD
- Optometrist
- Chicago, IL
National Provider Identifier
1750537072
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046010086
- Practice address
- 2110 W Roscoe St
Chicago, IL 60618-6387 - Phone
- (773) 975-2015
- Fax
- (773) 975-2476
- NPI assigned
- Aug 18, 2008
- Sex
- Female
- 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 | 046010086 | IL | Primary |
Addresses
Primary practice location
2110 W Roscoe St
Chicago, IL 60618-6387
Mailing address
2110 W Roscoe St
Chicago, IL 60618-6387
Phone (773) 975-2015
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130312000075 | IL | Order and Referring Only - Optometry | 6608936893 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southport Eye Associates LTD | Optometrist | Current | Accepting new patients |
| Visionworks, Inc | Past | Accepting new patients | |
| Visionworks, Inc. | Optometrist | Past | Accepting new patients |
Locations
3123 N Broadway St
Chicago, IL 60657
Phone (773) 880-5400
3539 N Southport Ave
Unit North
Chicago, IL 60657
Phone (773) 975-2015
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.
-
- Optometrist
- Chicago, IL
- NPI 1639302383
-
- Optometrist
- Niles, IL
- NPI 1831115906
-
- Eyewear Supplier
- Simpsonville, SC
- NPI 1699571166
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1219017600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1418688000000",
"number": "1750537072",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2110 W ROSCOE ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606186387",
"telephone_number": "773-975-2015",
"fax_number": "773-975-2476"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2110 W ROSCOE ST",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606186387",
"telephone_number": "773-975-2015",
"fax_number": "773-975-2476"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CAMERON",
"first_name": "JENNIFER",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-08-18",
"last_updated": "2014-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046010086",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.