Active NPI
Lauren Ristin, O.D.
- Optometrist
- Chicago, IL
National Provider Identifier
1801985742
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046-009889
- Practice address
- 820 S Damen Ave
170F
Chicago, IL 60612-3728 - Phone
- (312) 569-7501
- NPI assigned
- Oct 11, 2006
- Last updated
- Jan 11, 2011
- 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 | 046-009889 | IL | Primary |
Addresses
Primary practice location
820 S Damen Ave
170F
Chicago, IL 60612-3728
Mailing address
1600 Brophy Ave
Park Ridge, IL 60068-5234
Phone (847) 698-2026
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 212593001 | Other | IL | MEDICARE PTAN |
Other names 1
- Lauren Maloney
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046-009889 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ridge Optical | Optometrist | Past | Accepting new patients |
| Bartlett Vision Center PC | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Optometrist
- Bartlett, IL
- NPI 1477766699
-
- Durable Medical Equipment & Medical Supplies
- Park Ridge, IL
- NPI 1376656686
Optometrist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1294704000000",
"number": "1801985742",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 BROPHY AVE",
"city": "PARK RIDGE",
"state": "IL",
"postal_code": "600685234",
"telephone_number": "847-698-2026"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "820 S DAMEN AVE",
"address_2": "170F",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606123728",
"telephone_number": "312-569-7501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RISTIN",
"first_name": "LAUREN",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-11",
"last_updated": "2011-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046-009889",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "212593001",
"state": "IL"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LAUREN",
"last_name": "MALONEY",
"credential": "O.D.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.