Individual provider Active NPI

Christopher Dale Martin II, O.D.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1881618445
Registry record updated Oct 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-009427 Issued in IL
Practice address
4200 S Ashland Ave Unit 255
Chicago, IL 60609-2306
Phone
(708) 477-1986
NPI assigned
Jul 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-009427 IL Primary

Addresses

Primary practice location

4200 S Ashland Ave Unit 255
Chicago, IL 60609-2306

Mailing address

6541 27TH PL
Berwyn, IL 60402-2769
Phone (708) 477-1986

Other identifiers 2

IdentifierTypeStateIssuer
502720039OtherILMEDICARE PTAN
046009427MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-009427ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Special Eyes Optometrist Past Accepting new patients
Shopko Stores Operating Co. LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760400000000",
    "number": "1881618445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6541 27TH PL",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022769",
            "telephone_number": "708-477-1986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 S ASHLAND AVE UNIT 255",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606092306",
            "telephone_number": "708-477-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARTIN",
        "first_name": "CHRISTOPHER",
        "middle_name": "DALE",
        "name_suffix": "II",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-27",
        "last_updated": "2025-10-14",
        "certification_date": "2025-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009427",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "502720039",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009427",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.