Individual provider Active NPI

Elaine Anne Tancioco-Rokosz, O.D.

  • Optometrist
  • Skokie, IL
National Provider Identifier
1932258019
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Practice address
9450 Skokie Blvd
Skokie, IL 60077-1311
Phone
(847) 677-7202
Fax
(847) 677-1258
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X IL Primary

Addresses

Primary practice location

9450 Skokie Blvd
Skokie, IL 60077-1311

Mailing address

402 E Pine Lake Cir
Vernon Hills, IL 60061-1202
Phone (847) 968-2575

Other names 1

  • Elaine Anne Tancioco Other name

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
I20031229000431 IL Practitioner - Optometry 4082512009 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-009037ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932258019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 E PINE LAKE CIR",
            "city": "VERNON HILLS",
            "state": "IL",
            "postal_code": "600611202",
            "telephone_number": "847-968-2575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9450 SKOKIE BLVD",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600771311",
            "telephone_number": "847-677-7202",
            "fax_number": "847-677-1258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANCIOCO-ROKOSZ",
        "first_name": "ELAINE",
        "middle_name": "ANNE",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELAINE",
            "last_name": "TANCIOCO",
            "middle_name": "ANNE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.