Individual provider Active NPI

Jennifer Sue Harthan, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1801818026
Registry record updated Dec 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.009882 Issued in IL
Practice address
3241 S Michigan Ave
Chicago, IL 60616-3849
Phone
(312) 949-7000
Fax
(312) 949-7660
NPI assigned
Jul 24, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.009882 IL Primary

Addresses

Primary practice location

3241 S Michigan Ave
Chicago, IL 60616-3849

Mailing address

625 Deerfield Rd
Apt #405
Deerfield, IL 60015-3232
Phone (847) 514-8946

Other identifiers 1

IdentifierTypeStateIssuer
046009882MedicaidIL

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
I20060823000178 IL Practitioner - Optometry 1557364015 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Glenview Vision Care LLCGroup PAC ID 6800210980, 3 clinicians
Illinois College of OptometryGroup PAC ID 7416851639, 77 clinicians

Practice addresses (Care Compare)

1920 Waukegan Rd
Suite 1
Glenview, IL 60025-1756
Phone (847) 510-2111

3241 S Michigan Ave
Chicago, IL 60616-3878
Phone (312) 949-7751

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.009882ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Illinois College of Optometry Optometrist CurrentSince Aug 1, 2006 Accepting new patients

Locations

3241 S Michigan Ave
Chicago, IL 60616
Phone (312) 225-6200

1920 Waukegan Rd
Ste 1
Glenview, IL 60025
Phone (847) 510-2111

Interoperability endpoints

  • Direct secure messaging: jennifer.harthan.iei@direct.ico.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230508800000",
    "number": "1801818026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 DEERFIELD RD",
            "address_2": "APT #405",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600153232",
            "telephone_number": "847-514-8946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3241 S MICHIGAN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606163849",
            "telephone_number": "312-949-7000",
            "fax_number": "312-949-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTHAN",
        "first_name": "JENNIFER",
        "middle_name": "SUE",
        "name_prefix": "Miss",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-24",
        "last_updated": "2008-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.009882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009882",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.