Individual provider Active NPI

Adalina Kulbak, O.D.

  • Optometrist
  • Skokie, IL
National Provider Identifier
1972651636
Registry record updated Aug 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046-008697 Issued in IL
Practice address
9436 Karlov Ave
Skokie, IL 60076-1417
Phone
(224) 522-2722
NPI assigned
Jan 8, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 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 046-008697 IL Primary

Addresses

Primary practice location

9436 Karlov Ave
Skokie, IL 60076-1417

Mailing address

9436 Karlov Ave
Skokie, IL 60076-1417
Phone (224) 522-2722

Other identifiers 1

IdentifierTypeStateIssuer
046008697MedicaidIL

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
I20070611000026 IL Practitioner - Optometry 5294833547 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Illinois LLCGroup PAC ID 3577869965, 66 clinicians

Practice addresses (Care Compare)

463 Central Ave
Highland Park, IL 60035-2622
Phone (847) 266-6400

5408 N Clark St
Chicago, IL 60640-1210
Phone (773) 275-2020

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046-008697ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Half Day Optical LLC Optometrist CurrentSince Jul 1, 2019 Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist CurrentSince Aug 28, 2024 Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist CurrentSince Aug 28, 2024 Accepting new patients
Stonebrook Optical LLC Optometrist CurrentSince Jul 1, 2019 Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist Past Accepting new patients

Locations

464 W Half Day Rd
Buffalo Grove, IL 60089
Phone (847) 913-5545

5408 N Clark St
Chicago, IL 60640
Phone (773) 275-2020

6641 Grand Ave
Ste D
Gurnee, IL 60031
Phone (847) 856-1200

463 Central Ave
Highland Park, IL 60035
Phone (847) 266-6400

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 6

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": "1168214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1972651636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9436 KARLOV AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761417",
            "telephone_number": "224-522-2722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9436 KARLOV AVE",
            "city": "SKOKIE",
            "state": "IL",
            "postal_code": "600761417",
            "telephone_number": "224-522-2722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULBAK",
        "first_name": "ADALINA",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-08",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046-008697",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046008697",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Skokie, IL

Sources for this page

Verify at the official NPI Registry.