Active NPI
Diane S. Kirkorsky, O.D.
- Optometrist
- Northbrook, IL
National Provider Identifier
1801964614
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 46008756
- Practice address
- 35 Skokie Blvd
Northbrook, IL 60062-1607 - Phone
- (847) 714-9009
- Fax
- (847) 714-9598
- NPI assigned
- Dec 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 | 46008756 | IL | Primary |
Addresses
Primary practice location
35 Skokie Blvd
Northbrook, IL 60062-1607
Mailing address
35 Skokie Blvd
Northbrook, IL 60062-1607
Phone (847) 714-9009
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46008756 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Eyewear Supplier
- Fairview Heights, IL
- NPI 1891880977
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164931200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1801964614",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 SKOKIE BLVD",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600621607",
"telephone_number": "847-714-9009",
"fax_number": "847-714-9598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "35 SKOKIE BLVD",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600621607",
"telephone_number": "847-714-9009",
"fax_number": "847-714-9598"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRKORSKY",
"first_name": "DIANE",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "46008756",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Northbrook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.