Individual provider Active NPI

Chad Anthony Hartman, O.D.

  • Optometrist
  • Burbank, IL
National Provider Identifier
1982624367
Registry record updated Aug 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.009852 Issued in IL
Practice address
8525 S Harlem Ave
Burbank, IL 60459-2293
Phone
(708) 599-0050
Fax
(708) 599-1099
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.009852 IL Primary

Addresses

Primary practice location

8525 S Harlem Ave
Burbank, IL 60459-2293

Mailing address

8525 S Harlem Ave
Burbank, IL 60459-2293
Phone (708) 599-0050

Other identifiers 1

IdentifierTypeStateIssuer
046009852MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.009852ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Albina Optometric Optometrist PastSince Feb 8, 2012 Accepting new patients

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343779200000",
    "number": "1982624367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8525 S HARLEM AVE",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604592293",
            "telephone_number": "708-599-0050",
            "fax_number": "708-599-1099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8525 S HARLEM AVE",
            "city": "BURBANK",
            "state": "IL",
            "postal_code": "604592293",
            "telephone_number": "708-599-0050",
            "fax_number": "708-599-1099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTMAN",
        "first_name": "CHAD",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2012-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.009852",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009852",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burbank, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.