Advanced Eyecare of Hanover Park, Corp.

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

ADVANCED EYECARE OF HANOVER PARK, CORP.

Doing business as

Advanced Eyecare of Hanover Park

Practice address

1156 E Lake St
Hanover Park, IL 60133-5421

Phone

(630) 855-5542

NPI assigned

Mar 13, 2023

Last updated

Feb 21, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Grishma P PatelNPI 1164622874

Title

Owner

Phone

(630) 855-5542

Specialties & licenses 1

Addresses

Other names 1

• Advanced Eyecare of Hanover Park Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Grishma Premal Patel, O.D.

  • Optometrist
  • Wheaton, IL
  • NPI 1164622874
  Medicare reassignment Care Compare group NPD Authorized official
• Snehali A Upadhyay, OD

  • Optometrist
  • Chicago, IL
  • NPI 1861620833
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708473600000",
    "number": "1790486207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1325 N MAIN ST",
            "city": "WHEATON",
            "state": "IL",
            "postal_code": "601873579",
            "telephone_number": "630-668-4144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1156 E LAKE ST",
            "city": "HANOVER PARK",
            "state": "IL",
            "postal_code": "601335421",
            "telephone_number": "630-855-5542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED EYECARE OF HANOVER PARK, CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-13",
        "last_updated": "2024-02-21",
        "certification_date": "2024-02-21",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "GRISHMA",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-855-5542"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Eyecare of Hanover Park",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Eyecare of Hanover Park",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Optometrist in Hanover Park, IL
• Providers in Hanover Park, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.