Northewestern Opthalmic Institute

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

36093343 Issued in IL

Legal business name

NORTHEWESTERN OPTHALMIC INSTITUTE

Practice address

3633 West Lake Avenue
Suite 104
Glenview, IL 60026

Phone

(847) 832-3900

Fax

(847) 832-3904

NPI assigned

Dec 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Thomas E BourniasNPI 1386712180

Title

Dr

Phone

(847) 832-3900

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Thomas E. Bournias, M.D.

  • Ophthalmology Physician
  • Chicago, IL
  • NPI 1386712180
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363305600000",
    "number": "1881754570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3633 WEST LAKE AVENUE",
            "address_2": "SUITE 104",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "60026",
            "telephone_number": "847-832-3900",
            "fax_number": "847-832-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3633 WEST LAKE AVENUE",
            "address_2": "SUITE 104",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "60026",
            "telephone_number": "847-832-3900",
            "fax_number": "847-832-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEWESTERN OPTHALMIC INSTITUTE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-11",
        "last_updated": "2013-03-15",
        "status": "A",
        "authorized_official_last_name": "BOURNIAS",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DR",
        "authorized_official_telephone_number": "847-832-3900",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "36093343",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7797487",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036093343",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• North Suburban Ophthalmologists, S.C.
• Northfield Townshp HS Dist 225
• Northfield Townshp HS Dist 225
• Northland Hearing Centers, Inc.
• Northshore Healthsystem
• Northshore Medical Supplies

• Ophthalmology Physician in Glenview, IL
• Providers in Glenview, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2013; 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.