Active NPI
Danielle F Leong, O.D.
- Optometrist
- Chicago, IL
National Provider Identifier
1912294869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046010445
- Practice address
- 3241 S Michigan Ave
Chicago, IL 60616-3878 - Phone
- (312) 949-7211
- Fax
- (312) 949-7389
- NPI assigned
- Jun 29, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046010445 | IL | Primary |
Addresses
Primary practice location
3241 S Michigan Ave
Chicago, IL 60616-3878
Mailing address
3241 S Michigan Ave
Chicago, IL 60616-3878
Phone (312) 949-7211
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 502720043 | Other | IL | MEDICARE PTAN |
| 046010445 | Medicaid | IL |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 046010445 | IL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1309305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319500800000",
"number": "1912294869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3241 S MICHIGAN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606163878",
"telephone_number": "312-949-7211",
"fax_number": "312-949-7389"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3241 S MICHIGAN AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606163878",
"telephone_number": "312-949-7211",
"fax_number": "312-949-7389"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEONG",
"first_name": "DANIELLE",
"middle_name": "F",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-06-29",
"last_updated": "2011-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046010445",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "502720043",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "046010445",
"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 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.