Organization Active NPI

Goren Eye Associates, SC

  • Ophthalmology Physician
  • Chicago, IL
National Provider Identifier
1972794451
Registry record updated Aug 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
Legal business name
GOREN EYE ASSOCIATES, SC
Practice address
180 N Stetson Ave
Suite 3175
Chicago, IL 60601-6710
Phone
(312) 332-2262
NPI assigned
Aug 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2007

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

Authorized official

Name
Dr. Matthew Brent Goren, MDNPI 1891868709
Title
President
Phone
(312) 332-2262

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
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X IL Primary

Addresses

Primary practice location

180 N Stetson Ave
Suite 3175
Chicago, IL 60601-6710

Mailing address

180 N Stetson Ave
Suite 3175
Chicago, IL 60601-6710
Phone (312) 332-2262

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090507000021 IL Part B Supplier - Clinic/Group Practice 3678621489 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, IL; Des Plaines, IL

National Provider Directory

National Provider Directory

Locations

180 N Stetson Ave
Ste 3175
Chicago, IL 60601
Phone (312) 332-2262

8901 Golf Rd
Ste 301
Des Plaines, IL 60016
Phone (847) 297-8700

1420 Renaissance Dr
Ste 315
Park Ridge, IL 60068
Phone (224) 251-7930

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186531200000",
    "number": "1972794451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 N STETSON AVE",
            "address_2": "SUITE 3175",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606016710",
            "telephone_number": "312-332-2262"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 N STETSON AVE",
            "address_2": "SUITE 3175",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606016710",
            "telephone_number": "312-332-2262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOREN EYE ASSOCIATES, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-08-08",
        "status": "A",
        "authorized_official_last_name": "GOREN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "BRENT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-332-2262",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": null,
            "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 Aug 8, 2007; 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.