Individual provider Active NPI

Stacy Olswang, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1851440010
Registry record updated May 10, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-009152 Issued in IL
Practice address
3143 W Devon Ave
Chicago, IL 60659-1424
Phone
(773) 764-5300
NPI assigned
Jan 9, 2007
Last updated
May 10, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 10, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-009152 IL Primary

Addresses

Primary practice location

3143 W Devon Ave
Chicago, IL 60659-1424

Mailing address

2950 W Chase Ave
Chicago, IL 60645-1214
Phone (773) 743-3171

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
I20091119000273 IL Practitioner - Optometry 0749328318 Practice locations: Skokie, IL

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
State University of New York - State College Optometry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8707 Skokie Blvd
Suite 308
Skokie, IL 60077-2281
Phone (224) 601-6161

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-009152ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Stacy Olswang Optometrist CurrentSince Jun 28, 2020 Accepting new patients
Village Crossing Optical PastSince Oct 20, 2009 Accepting new patients

Locations

8707 Skokie Blvd
Ste 308
Skokie, IL 60077
Phone (224) 601-6161

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304985600000",
    "number": "1851440010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2950 W CHASE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606451214",
            "telephone_number": "773-743-3171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3143 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591424",
            "telephone_number": "773-764-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLSWANG",
        "first_name": "STACY",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2011-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.