Individual provider Active NPI

Todd G Cohan, O.D

  • Optometrist
  • Long Grove, IL
National Provider Identifier
1841244878
Registry record updated Jun 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009356 Issued in IL
Practice address
4160 Il Rte 83
Suite 107
Long Grove, IL 60047
Phone
(847) 955-9393
Fax
(847) 955-9857
NPI assigned
May 22, 2006
Last updated
Jun 25, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046009356 IL Primary

Addresses

Primary practice location

4160 Il Rte 83
Suite 107
Long Grove, IL 60047

Mailing address

4160 Il Route 83
Suite 107
Long Grove, IL 60047-8034
Phone (847) 955-9393

Other identifiers 3

IdentifierTypeStateIssuer
0001604768OtherILBLUE CROSS BLUE SHIELD
P00005501OtherRAILROAD MEDICARE
046009356MedicaidIL

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
I20040329000458 IL Practitioner - Optometry 5294627725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Forsight Vision, LTDGroup PAC ID 6709964513, 5 clinicians

Practice addresses (Care Compare)

4160 Il Route 83
Suite 107
Long Grove, IL 60047-8034
Phone (847) 955-9393

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046009356ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Midwest Dry Eye Center LLC Optometrist Current Accepting new patients
Forsight Vision, LTD Optometrist CurrentSince Jan 1, 2008 Accepting new patients

Locations

191 Waukegan Rd
Ste 120
Northfield, IL 60093
Phone (847) 278-9257

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.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403654400000",
    "number": "1841244878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4160 IL ROUTE 83",
            "address_2": "SUITE 107",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "600478034",
            "telephone_number": "847-955-9393",
            "fax_number": "847-955-9857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4160 IL RTE 83",
            "address_2": "SUITE 107",
            "city": "LONG GROVE",
            "state": "IL",
            "postal_code": "60047",
            "telephone_number": "847-955-9393",
            "fax_number": "847-955-9857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COHAN",
        "first_name": "TODD",
        "middle_name": "G",
        "name_prefix": "Dr.",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2014-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009356",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0001604768",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00005501",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009356",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Grove, IL

Sources for this page

Verify at the official NPI Registry.