Individual provider Active NPI

Amy Chang, O.D.

  • Optometrist
  • Bloomingdale, IL
National Provider Identifier
1861705055
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010335 Issued in IL
Practice address
314 W Army Trail Rd
Bloomingdale, IL 60108-2300
Phone
(847) 466-8758
Fax
(630) 295-8261
NPI assigned
Jul 16, 2010
Last updated
Oct 19, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010335 IL Primary

Addresses

Primary practice location

314 W Army Trail Rd
Bloomingdale, IL 60108-2300

Mailing address

314 W Army Trail Rd
Bloomingdale, IL 60108-2300
Phone (847) 466-8758

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
I20101207000284 IL Practitioner - Optometry 7719174564 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046010335ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Kats Eye Care, P.C. Optometrist CurrentSince Dec 17, 2010 Accepting new patients
Dr. Imran Ali P.C. Optometrist PastSince Jun 3, 2015 Accepting new patients
Izza Professional Corporation Optometrist PastSince Jun 23, 2024 Accepting new patients
Maxivision, PC Optometrist Past Accepting new patients
Downers Grove Eye Center, PC Optometrist Past Accepting new patients

Locations

314 W Army Trail Rd
Bloomingdale, IL 60108
Phone (630) 893-5382

2189 75th St
Darien, IL 60561
Phone (630) 434-0495

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 5

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": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1861705055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "314 W ARMY TRAIL RD",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082300",
            "telephone_number": "847-466-8758",
            "fax_number": "630-295-8261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 W ARMY TRAIL RD",
            "city": "BLOOMINGDALE",
            "state": "IL",
            "postal_code": "601082300",
            "telephone_number": "847-466-8758",
            "fax_number": "630-295-8261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-16",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomingdale, IL

Sources for this page

Verify at the official NPI Registry.