Tiffany L Polanek, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046009299 Issued in IL

Practice address

3241 S Michigan Ave
Chicago, IL 60616-3849

Phone

(312) 225-6200

Fax

(312) 949-7660

NPI assigned

Sep 6, 2005

Last updated

Dec 29, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Tiffany L Lueken Former name

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

Ferris State College - College of Optometry, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christina J. Levi O D P C.Group PAC ID 9436210762, 63 clinicians

Loyola University Medical CenterGroup PAC ID 3779488903, 917 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Loyola University Medical Center Hospital, Maywood, IL, CCN 140276

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Christina J. Levi O D P C

  dba Edwardsville Vision Center

  • Optometrist
  • Edwardsville, IL
  • NPI 1477703411
  Medicare reassignment Care Compare group NPD
• Loyola University Medical Center

  • General Practice Physician
  • Maywood, IL
  • NPI 1336159961
  Medicare reassignment Care Compare group NPD
• Loyola University Medical Center

  dba Mulcahy Pharmacy

  • Community/Retail Pharmacy
  • Maywood, IL
  • NPI 1184789299
  NPD
• Christina J. Levi O D P C

  dba Edwardsville Vision Center

  • Optometrist
  • Edwardsville, IL
  • NPI 1033261904
  NPD (past)
• Eaton Rapids Eye Care PC

  • Optometrist
  • Eaton Rapids, MI
  • NPI 1861611626
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Loyola University Medical Center

  dba Foster G. McGaw Hospital

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  Care Compare affiliation
• Loyola University Medical Center

  dba Loyola University Medical Center Cancer Center

  • General Acute Care Hospital
  • Tinley Park, IL
  • NPI 1427752013
  Care Compare affiliation

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230508800000",
    "number": "1952395014",
    "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": "606163849",
            "telephone_number": "312-949-7146",
            "fax_number": "312-949-7660"
        },
        {
            "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": "606163849",
            "telephone_number": "312-225-6200",
            "fax_number": "312-949-7660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLANEK",
        "first_name": "TIFFANY",
        "middle_name": "L",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-06",
        "last_updated": "2008-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009299",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIFFANY",
            "last_name": "LUEKEN",
            "middle_name": "L",
            "credential": "OD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• David Polak, KINESIOTHERAPIST
• Aravind Reddy Polam, MD
• Vinathi Sainaga Polamraju, MD
• Angie Polanco, MD
• Sarah Glen Poland, MD
• Maxim Alexandrovich Polansky, M.D.
• Polaris Pulse Inc
• Breanna Polascik
• Megan Polchopek, BCBA
• Carly Polcyn, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; 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.