Individual provider Active NPI

Anh Dao Vu, OD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1902680523
Registry record updated Aug 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
04601178 Issued in IL
Practice address
3428 N Southport Ave
Chicago, IL 60657-0004
Phone
(773) 269-5989
NPI assigned
Aug 23, 2023
Last updated
Aug 23, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 04601178 IL Primary

Addresses

Primary practice location

3428 N Southport Ave
Chicago, IL 60657-0004

Mailing address

1620 S Michigan Ave Unit 1103
Chicago, IL 60616-4694
Phone (773) 983-0914

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
I20241002003691 IL Practitioner - Optometry 2769913672 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2023
Medicare assignment
May accept Medicare assignment
Group practices
Luxottica of America IncGroup PAC ID 2567366180, 6 clinicians

Practice addresses (Care Compare)

3428 N Southport Ave
Chicago, IL 60657-0004
Phone (773) 269-5989

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04601178ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Luxottica of America Inc CurrentSince Aug 15, 2024 Accepting new patients
Luxottica of America Inc. CurrentSince Aug 15, 2024 Accepting new patients
Lenscrafters Optometrist Past Accepting new patients

Locations

900 W North Ave
Chicago, IL 60642
Phone (312) 690-3526

4000 Luxottica Pl
Mason, OH 45040
Phone (513) 765-2155

Organizations & group practices 3

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": "1692748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1902680523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 S MICHIGAN AVE UNIT 1103",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606164694",
            "telephone_number": "773-983-0914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3428 N SOUTHPORT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606570004",
            "telephone_number": "773-269-5989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VU",
        "first_name": "ANH DAO",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-23",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "04601178",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.