Individual provider Active NPI

Deborah L Klesken, OD

  • Optometrist
  • Hoffman Estates, IL
National Provider Identifier
1780806448
Registry record updated May 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046008402 Issued in IL
Practice address
1415 Palatine Rd
Hoffman Estates, IL 60195-1196
Phone
(847) 776-8900
Fax
(847) 776-8922
NPI assigned
May 3, 2007
Last updated
May 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046008402 IL Primary

Addresses

Primary practice location

1415 Palatine Rd
Hoffman Estates, IL 60195-1196

Mailing address

1415 Palatine Rd
Hoffman Estates, IL 60195-1196
Phone (847) 776-8900

Other identifiers 3

IdentifierTypeStateIssuer
IL1228OtherILEYEMED
346002263OtherILCONTROLLED SUBSTANCE
046008402OtherILLICENSED OPTOMETRIST

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
I20080902000582 IL Practitioner - Optometry 8224103296 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Khurana Family Eyecare, PLLC Optometrist CurrentSince Sep 17, 2023 Accepting new patients

Locations

8400 W North Ave
Melrose Park, IL 60160
Phone (708) 397-2905

Organizations & group practices 1

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652140800000",
    "number": "1780806448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 PALATINE RD",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601951196",
            "telephone_number": "847-776-8900",
            "fax_number": "847-776-8922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1415 PALATINE RD",
            "city": "HOFFMAN ESTATES",
            "state": "IL",
            "postal_code": "601951196",
            "telephone_number": "847-776-8900",
            "fax_number": "847-776-8922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLESKEN",
        "first_name": "DEBORAH",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2022-05-10",
        "certification_date": "2022-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046008402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EYEMED",
            "identifier": "IL1228",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROLLED SUBSTANCE",
            "identifier": "346002263",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED OPTOMETRIST",
            "identifier": "046008402",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hoffman Estates, IL

Sources for this page

Verify at the official NPI Registry.