NPIMap

Organization Active NPI

Old Town Eye Care LLC

Doing business as Pearle Vision Old Town

  • Optometrist
  • Chicago, IL
National Provider Identifier
1861213472
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
OLD TOWN EYE CARE LLC
Doing business as
Pearle Vision Old Town
Practice address
400 W Division St Ste a
Chicago, IL 60610-2981
Phone
(312) 274-1212
NPI assigned
Oct 17, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Authorized official

Name
Dr. Tajal Patel Darne, O.D.NPI 1306038583
Title
Owner
Phone
(832) 607-2055

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

400 W Division St Ste a
Chicago, IL 60610-2981

Mailing address

2501 Chatham Rd Ste R
Springfield, IL 62704-4188
Phone (832) 607-2055

Other names 1

  • PEARLE VISION OLD TOWN Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250226000843 IL Part B Supplier - Clinic/Group Practice 9830619493 Receives reassigned benefits from 9 practitioners
Practice locations: Chicago, IL

National Provider Directory

National Provider Directory

Locations

400 W Division St
Chicago, IL 60610
Phone (312) 274-1212

400 W Division St
Ste A
Chicago, IL 60610
Phone (312) 274-1212

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1861213472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2501 CHATHAM RD STE R",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044188",
            "telephone_number": "832-607-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W DIVISION ST STE A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606102981",
            "telephone_number": "312-274-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OLD TOWN EYE CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "PATEL DARNE",
        "authorized_official_first_name": "TAJAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "832-607-2055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PEARLE VISION OLD TOWN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Oct 17, 2024; 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.