Mark D Wilmoth, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

046-009127 Issued in IL

Practice address

7451 Woodward Ave
Suite 101
Woodridge, IL 60517

Phone

(630) 663-9112

Fax

(630) 663-9228

NPI assigned

May 2, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wow Vision PC

  • Optometrist
  • Woodridge, IL
  • NPI 1104156009
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647734400000",
    "number": "1912965823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7451 WOODWARD AVE",
            "address_2": "SUITE 101",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "60517",
            "telephone_number": "630-663-9112",
            "fax_number": "630-663-9228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7451 WOODWARD AVE",
            "address_2": "SUITE 101",
            "city": "WOODRIDGE",
            "state": "IL",
            "postal_code": "60517",
            "telephone_number": "630-663-9112",
            "fax_number": "630-663-9228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILMOTH",
        "first_name": "MARK",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2022-03-20",
        "certification_date": "2022-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn Wiggan, MSPT
• Williams and Eaton Live and Learn Together
• Fahamisha Williams, LCSW
• Taylor Williams, LSW
• Amy K Williamson, ED.D.
• Justine N. Wilson, APN-CNP
• Kendall M Wilson, LCSW
• Michael Wingerter, DPT
• Kathryn Wirth, DPT
• Heather L Wodziak, P.T., D.P.T

• Optometrist in Woodridge, IL
• Providers in Woodridge, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.