Individual provider Active NPI

Nicole Collette Lang, OD

  • Optometrist
  • Orland Park, IL
National Provider Identifier
1972332005
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.011874 Issued in IL
Practice address
11319 W 143Rd St
Orland Park, IL 60467-7221
Phone
(708) 460-2020
NPI assigned
Jul 29, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.011874 IL Primary

Addresses

Primary practice location

11319 W 143Rd St
Orland Park, IL 60467-7221

Mailing address

11319 W 143Rd St
Orland Park, IL 60467-7221
Phone (708) 460-2020

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
I20240913000738 IL Practitioner - Optometry 8022558329 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Eye Was Framed Optical LTDGroup PAC ID 0345259925, 2 clinicians

Practice addresses (Care Compare)

11319 W 143Rd St
Orland Park, IL 60467-7221
Phone (708) 460-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.011874ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Eye Was Framed Optical LTD Optometrist CurrentSince Aug 31, 2024 Accepting new patients

Locations

11319 W 143rd St
Orland Park, IL 60467
Phone (708) 460-2020

Organizations & group practices 1

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": "1722211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1972332005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11319 W 143RD ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604677221",
            "telephone_number": "708-460-2020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11319 W 143RD ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604677221",
            "telephone_number": "708-460-2020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANG",
        "first_name": "NICOLE",
        "middle_name": "COLLETTE",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-07-29",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

Verify at the official NPI Registry.