Active NPI
Andjela Bursac, OD
- Optometrist
- Norridge, IL
National Provider Identifier
1912732686
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046.011919
- Practice address
- 4214 N Harlem Ave
Norridge, IL 60706-1293 - Phone
- (708) 453-7005
- NPI assigned
- Sep 3, 2024
- Last updated
- Sep 3, 2024
- 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 | 046.011919 | IL | Primary |
Addresses
Primary practice location
4214 N Harlem Ave
Norridge, IL 60706-1293
Mailing address
4214 N Harlem Ave
Norridge, IL 60706-1293
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046.011919 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Luxottica of America Inc | Past | Accepting new patients | |
| Luxottica of America Inc. | 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, 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": "1725321600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1725321600000",
"number": "1912732686",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4214 N HARLEM AVE",
"city": "NORRIDGE",
"state": "IL",
"postal_code": "607061293"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4214 N HARLEM AVE",
"city": "NORRIDGE",
"state": "IL",
"postal_code": "607061293",
"telephone_number": "708-453-7005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURSAC",
"first_name": "ANDJELA",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-03",
"last_updated": "2024-09-03",
"certification_date": "2024-09-03",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046.011919",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Norridge, IL
- Sohail Bhatti
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- Boomers Medical Gear PLLC
- Haley Loretta Boswick, OD
- Thao H Bui, D.M.D
- Cherlyne Ferrer Carlos, ATC
- Andrea F Casali, L.M.T.
- Wendel M Catangay, FNP-C
- Central Baptist Home for the Aged
- Paul Cesario, RPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.