Active NPI
Chicagoland Cataract and Lasik SC
- Ophthalmology Physician
- Libertyville, IL
National Provider Identifier
1891348355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- Legal business name
- CHICAGOLAND CATARACT AND LASIK SC
- Practice address
- 1880 W Winchester Rd Ste 105
Libertyville, IL 60048-5321 - Phone
- (847) 362-3811
- Fax
- (847) 362-0428
- NPI assigned
- Jul 23, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Hercules D Logothetis, MD
- Title
- Owner
- Phone
- (847) 362-3811
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | Primary |
Addresses
Primary practice location
1880 W Winchester Rd Ste 105
Libertyville, IL 60048-5321
Mailing address
1880 W Winchester Rd Ste 105
Libertyville, IL 60048-5321
Phone (847) 362-3811
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191014003536 | IL | Part B Supplier - Clinic/Group Practice | 4880925346 |
Receives reassigned benefits from 7 practitioners Practice locations: Libertyville, IL |
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 7
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": "1563840000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1578355200000",
"number": "1891348355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1880 W WINCHESTER RD STE 105",
"city": "LIBERTYVILLE",
"state": "IL",
"postal_code": "600485321",
"telephone_number": "847-362-3811",
"fax_number": "847-362-0428"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1880 W WINCHESTER RD STE 105",
"city": "LIBERTYVILLE",
"state": "IL",
"postal_code": "600485321",
"telephone_number": "847-362-3811",
"fax_number": "847-362-0428"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHICAGOLAND CATARACT AND LASIK SC",
"organizational_subpart": "NO",
"enumeration_date": "2019-07-23",
"last_updated": "2020-01-07",
"certification_date": "2020-01-07",
"status": "A",
"authorized_official_last_name": "LOGOTHETIS",
"authorized_official_first_name": "HERCULES",
"authorized_official_middle_name": "D",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "847-362-3811",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Libertyville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2020; 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.