NPIMap

Organization Active NPI

Austin-Cleetus LTD

Doing business as Pearle Vision

  • Optometrist
  • Oakbrook Terrace, IL
National Provider Identifier
1831232495
Registry record updated Nov 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
AUSTIN-CLEETUS LTD
Doing business as
Pearle Vision
Practice address
17W685 Roosevelt Rd
Oakbrook Terrace, IL 60181-3545
Phone
(630) 916-8282
Fax
(630) 916-6873
NPI assigned
Feb 14, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2023

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

Authorized official

Name
Ms. Jennifer Sullivan
Title
Owner
Phone
(630) 408-4604

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193200000X MULTI-SPECIALTY GROUP 152W00000X Primary
Eyewear Supplier 332H00000X

Addresses

Primary practice location

17W685 Roosevelt Rd
Oakbrook Terrace, IL 60181-3545

Mailing address

17W685 Roosevelt Rd
Oakbrook Terrace, IL 60181-3545
Phone (630) 916-8282

Other names 1

  • Pearle Vision Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130819000031 IL Part B Supplier - Clinic/Group Practice 2860634011 Receives reassigned benefits from 8 practitioners
Practice locations: Oakbrook Terrace, IL

National Provider Directory

National Provider Directory

Locations

581 E Roosevelt Rd
Lombard, IL 60148
Phone (630) 916-8282

17W685 Roosevelt Rd
Oakbrook Terrace, IL 60181
Phone (630) 916-8282

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699747200000",
    "number": "1831232495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17W685 ROOSEVELT RD",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813545",
            "telephone_number": "630-916-8282",
            "fax_number": "630-916-6873"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17W685 ROOSEVELT RD",
            "city": "OAKBROOK TERRACE",
            "state": "IL",
            "postal_code": "601813545",
            "telephone_number": "630-916-8282",
            "fax_number": "630-916-6873"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUSTIN-CLEETUS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-14",
        "last_updated": "2023-11-12",
        "certification_date": "2023-11-12",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-408-4604",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332H00000X",
            "taxonomy_group": "",
            "desc": "Eyewear Supplier",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pearle Vision",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pearle Vision",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Oakbrook Terrace, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2023; 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.