Kelly Aung Chinosornvatana, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046010365 Issued in IL

Practice address

2003 Montgomery Rd Ste 104
Aurora, IL 60504-9059

Phone

(630) 425-8221

NPI assigned

Jul 9, 2010

Last updated

Mar 27, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Eyemax Inc.Group PAC ID 0840528279, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Eyemax Inc.

  • Optometrist
  • Aurora, IL
  • NPI 1902388754
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1278633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1851603666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 MONTGOMERY RD STE 104",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605049059",
            "telephone_number": "630-425-8221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 MONTGOMERY RD STE 104",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605049059",
            "telephone_number": "630-425-8221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHINOSORNVATANA",
        "first_name": "KELLY",
        "middle_name": "AUNG",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-09",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chicago Medical and Pain Associates LTD.
• Chicago Pediatric Dentistry and Orthodontics - Premier PLLC (Aurora Pediatric Dentistry)
• Chicago Vein Centers PLLC (Chicago Vein Centers)
• Chicagoland Counseling PLLC (Ellie Mental Health)
• Chicagoland Spine and Sport LLC (Chicagoland Spine and Sport)
• Bharath Kumar Reddy Chinta, DC
• Melissa Chiquito
• Chiropractic Back & Neck Center PC
• Brianna Chmielewski
• Jin H. Choi, D.D.S.

• Optometrist in Aurora, IL
• Providers in Aurora, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.