Individual provider Active NPI

Courtney Beasley

  • Optometrist
  • Oak Park, IL
National Provider Identifier
1780176065
Registry record updated Jun 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046011178 Issued in IL
Practice address
1100 Lake St Ste 180
Oak Park, IL 60301-1028
Phone
(708) 383-7240
NPI assigned
Jun 3, 2018
Last updated
Jun 3, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046011178 IL Primary

Addresses

Primary practice location

1100 Lake St Ste 180
Oak Park, IL 60301-1028

Mailing address

458 Canterbury Dr
Carol Stream, IL 60188-3914
Phone (630) 234-5643

Other practice location 1

698 Roosevelt Rd
Glen Ellyn, IL 60137-5819
Phone (630) 545-2020

Other practice location 2

160 Danada Sq W Ste A8
Wheaton, IL 60189-2041
Phone (630) 752-0595

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
I20180713000817 IL Practitioner - Optometry 0547516007 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rosin Optical Co IncGroup PAC ID 8022921758, 51 clinicians

Practice addresses (Care Compare)

698 Roosevelt Rd
Glen Ellyn, IL 60137-5819
Phone (630) 545-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rosin Optical Co., Inc Optometrist Current Accepting new patients
Rosin Optical Co., Inc. Optometrist CurrentSince Jun 12, 2018 Accepting new patients
Rosin Optical Co. Inc. Optometrist CurrentSince Jun 12, 2018 Accepting new patients
Comprehensive Eyecare Physicians PC Past Accepting new patients

Locations

6235 Cermak Rd
Berwyn, IL 60402
Phone (708) 749-2020

145 Ogden Ave
Downers Grove, IL 60515
Phone (630) 749-2020

698 Roosevelt Rd
Glen Ellyn, IL 60137
Phone (630) 545-2020

1100 Lake St
Ste 180
Oak Park, IL 60301
Phone (708) 383-7240

160 Danada Sq W
Ste A8
Wheaton, IL 60189
Phone (630) 752-0595

1706 E Roosevelt Rd
Wheaton, IL 60187
Phone (630) 653-8885

Organizations & group practices 4

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": "1527984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1527984000000",
    "number": "1780176065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "458 CANTERBURY DR",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601883914",
            "telephone_number": "630-234-5643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 LAKE ST STE 180",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603011028",
            "telephone_number": "708-383-7240"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "698 Roosevelt Rd",
            "address_purpose": "LOCATION",
            "city": "Glen Ellyn",
            "state": "IL",
            "postal_code": "601375819",
            "country_code": "US",
            "telephone_number": "630-545-2020",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "160 Danada Sq W Ste A8",
            "address_purpose": "LOCATION",
            "city": "Wheaton",
            "state": "IL",
            "postal_code": "601892041",
            "country_code": "US",
            "telephone_number": "630-752-0595",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BEASLEY",
        "first_name": "COURTNEY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-03",
        "last_updated": "2018-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046011178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

Verify at the official NPI Registry.