NPIMap

Organization Active NPI

Central Dupage Vision Center Inc.

  • Optometrist
  • Winfield, IL
National Provider Identifier
1972841393
Registry record updated Jul 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046009463 Issued in IL
Legal business name
CENTRAL DUPAGE VISION CENTER INC.
Practice address
27W185 Geneva Rd
Winfield, IL 60190-2058
Phone
(630) 668-2020
Fax
(630) 668-0308
NPI assigned
Jan 18, 2013
Last updated
Jul 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2013

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

Authorized official

Name
Atha Hyderi, O.D.NPI 1689617375
Title
Owner
Phone
(630) 668-2020

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 046009463 IL Primary

Addresses

Primary practice location

27W185 Geneva Rd
Winfield, IL 60190-2058

Mailing address

27W185 Geneva Rd
Winfield, IL 60190-2058
Phone (630) 668-2020

Other identifiers 1

IdentifierTypeStateIssuer
046009463MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130625000057 IL Part B Supplier - Clinic/Group Practice 9335388347 Receives reassigned benefits from 7 practitioners
Practice locations: Winfield, IL

National Provider Directory

National Provider Directory

Locations

27W185 Geneva Rd
Winfield, IL 60190
Phone (630) 668-2020

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1358467200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1372809600000",
    "number": "1972841393",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27W185 GENEVA RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601902058",
            "telephone_number": "630-668-2020",
            "fax_number": "630-668-0308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27W185 GENEVA RD",
            "city": "WINFIELD",
            "state": "IL",
            "postal_code": "601902058",
            "telephone_number": "630-668-2020",
            "fax_number": "630-668-0308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL DUPAGE VISION CENTER INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-18",
        "last_updated": "2013-07-03",
        "status": "A",
        "authorized_official_last_name": "HYDERI",
        "authorized_official_first_name": "ATHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-668-2020",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009463",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009463",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; 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.