Active NPI
Inna Rogoff, O.D.
- Optometrist
- Gurnee, IL
National Provider Identifier
1780731380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046008861
- Practice address
- 6170 Grand Ave
Ste 451
Gurnee, IL 60031-5263 - Fax
- (847) 677-5864
- NPI assigned
- Jan 4, 2007
- 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 | 046008861 | IL | Primary |
Addresses
Primary practice location
6170 Grand Ave
Ste 451
Gurnee, IL 60031-5263
Mailing address
3522 Dempster St
Skokie, IL 60076-2340
Phone (847) 675-4747
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 |
|---|---|---|---|---|
| I20040121000044 | IL | Practitioner - Optometry | 5991607095 | Practice locations: Gurnee, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6170 Grand Ave
Gurnee, IL 60031-5263
Phone (847) 962-9648
6170 W Grand Ave
Suite 451
Gurnee, IL 60031-5263
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046008861 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Uhlemann Optical Company | Optometrist | Past | Accepting new patients |
| Crystal Lake Optical Inc. | Optometrist | Past | Accepting new patients |
Organizations & group practices 2
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
- Crystal Lake, IL
- NPI 1124269030
-
- Optometrist
- Skokie, IL
- NPI 1225154404
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1501113600000",
"number": "1780731380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3522 DEMPSTER ST",
"city": "SKOKIE",
"state": "IL",
"postal_code": "600762340",
"telephone_number": "847-675-4747",
"fax_number": "847-677-5864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6170 GRAND AVE",
"address_2": "STE 451",
"city": "GURNEE",
"state": "IL",
"postal_code": "600315263",
"fax_number": "847-677-5864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROGOFF",
"first_name": "INNA",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2017-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046008861",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Gurnee, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2017; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.