Jeffrey D Dzik, O.D.
Individual provider Active NPI Optometrist · Princeton, IL
NPI 1912932807 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1912932807
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- Practice address
- 2111 Claude Bailey Pkwy
Princeton, IL 61356-8618 - Phone
- (815) 875-4521
- NPI assigned
- Jul 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2111 Claude Bailey Pkwy
Princeton, IL 61356-8618
Phone (815) 879-3210
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20060831000031 | IL | Practitioner - Optometry | 4981608106 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jeffrey D Dzik OD & Associates LLC | Optometrist | Current |
Accepting new patients |
Locations
2111 Claude Bailey Pkwy
Princeton, IL 61356
Phone (815) 875-4521
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | IL | Yes |
Addresses
Primary practice location
2111 Claude Bailey Pkwy
Princeton, IL 61356-8618
Mailing address
3 Kimberly
Spring Valley, IL 61362
Other providers in Princeton, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.