Active NPI
Diane Lee, OD
- Optometrist
- Chicago, IL
National Provider Identifier
1982868188
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046010120
- Practice address
- 4100 N Cicero Ave
Chicago, IL 60641-1808 - Phone
- (773) 427-9378
- NPI assigned
- Jul 16, 2008
- Last updated
- Feb 23, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 14656 | CA | |
| Optometrist | 152W00000X | 046010120 | IL | Primary |
Addresses
Primary practice location
4100 N Cicero Ave
Chicago, IL 60641-1808
Mailing address
280 Oakbrook Ctr
Oak Brook, IL 60523-1841
Phone (630) 368-1634
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046010120 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Visionworks, Inc | Past | Accepting new patients | |
| Visionworks, Inc. | Optometrist | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645574400000",
"number": "1982868188",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 OAKBROOK CTR",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605231841",
"telephone_number": "630-368-1634"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4100 N CICERO AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606411808",
"telephone_number": "773-427-9378"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LEE",
"first_name": "DIANE",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-07-16",
"last_updated": "2022-02-23",
"certification_date": "2022-02-23",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "CA",
"license": "14656",
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046010120",
"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 Feb 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.