NPIMap

Organization Active NPI

Ageless Eye Care P.C.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1962637439
Registry record updated Sep 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-009794 Issued in IL
Legal business name
AGELESS EYE CARE P.C.
Practice address
329 W 18TH St
#311
Chicago, IL 60616-1120
Phone
(312) 952-4847
NPI assigned
May 27, 2009
Last updated
Sep 16, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2020

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

Authorized official

Name
Dr. Luis Lewis, O.D.NPI 1437142973
Title
President/Optometrist
Phone
(312) 929-3340

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046-009794 IL Primary

Addresses

Primary practice location

329 W 18TH St
#311
Chicago, IL 60616-1120

Mailing address

329 W 18TH St
#311
Chicago, IL 60616-1120
Phone (312) 929-3340

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100120000617 IL Part B Supplier - Clinic/Group Practice 9638211253 Receives reassigned benefits from 8 practitioners
Practice locations: Loves Park, IL; Palos Heights, IL; Naperville, IL; Lemont, IL; Crete, IL; Chicago, IL; Bolingbrook, IL

National Provider Directory

National Provider Directory

Locations

329 W 18th St
Ste 311
Chicago, IL 60616
Phone (312) 952-4847

3730 W Bryn Mawr Ave
Chicago, IL 60659
Phone (773) 534-5180

7342 S Hoyne Ave
Chicago, IL 60636
Phone (773) 535-9100

8555 S Michigan Ave
Chicago, IL 60619
Phone (773) 535-3000

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1243382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600214400000",
    "number": "1962637439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 W 18TH ST",
            "address_2": "#311",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606161120",
            "telephone_number": "312-929-3340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 W 18TH ST",
            "address_2": "#311",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606161120",
            "telephone_number": "312-952-4847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AGELESS EYE CARE P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-27",
        "last_updated": "2020-09-16",
        "certification_date": "2020-09-16",
        "status": "A",
        "authorized_official_last_name": "LEWIS",
        "authorized_official_first_name": "LUIS",
        "authorized_official_title_or_position": "PRESIDENT/OPTOMETRIST",
        "authorized_official_telephone_number": "312-929-3340",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-009794",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.