| |
1325 N Main St, Wheaton, IL 60187-3579 | |
(630) 668-4144 | |
(630) 668-7559 |
Full Name | |
---|---|
Type | Facility |
Speciality | Optometrist |
Location | 1325 N Main St, Wheaton, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1134453897 | NPI | - | NPPES |
046009678 | Medicaid | IL | |
1134453897 | Medicaid | IL |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | 046-009678 (Illinois) | Primary |
Provider Name | Grishma P Patel |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1164622874 PECOS PAC ID: 7719944974 Enrollment ID: I20041220000460 |
Provider Name | Keith E Hougas |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1437274297 PECOS PAC ID: 6305898578 Enrollment ID: I20050217000140 |
Provider Name | Avery N Shulman |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1174532840 PECOS PAC ID: 7719045103 Enrollment ID: I20081029000731 |
Provider Name | Stephen A Shulman |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1962581306 PECOS PAC ID: 8325192107 Enrollment ID: I20090812000895 |
Provider Name | Payal Patel |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1013158674 PECOS PAC ID: 1355495623 Enrollment ID: I20090820000677 |
Provider Name | Amreen Farooqi |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1770919235 PECOS PAC ID: 2769607852 Enrollment ID: I20140703000969 |
Provider Name | Maja Hadziahmetovic |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1396195228 PECOS PAC ID: 6709179500 Enrollment ID: I20160801000139 |
Provider Name | Constance Copeland |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1508857202 PECOS PAC ID: 6002823564 Enrollment ID: I20170927000721 |
Provider Name | Jonathan Mark Ismond |
---|---|
Provider Type | Practitioner - Optometry |
Provider Identifiers | NPI Number: 1578133211 PECOS PAC ID: 7416359591 Enrollment ID: I20210817001549 |
Mailing Address | Practice Location Address |
---|---|
1325 N Main St, Wheaton, IL 60187-3579 Ph: (630) 668-4144 | 1325 N Main St, Wheaton, IL 60187-3579 Ph: (630) 668-4144 |
Dr. Ann E Clark, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 2015 N Main St, Wheaton, IL 60187 Phone: 630-668-8250 Fax: 630-668-9561 | |
Hajera Shahreen Khan, O.D. Optometrist Medicare: Not Enrolled in Medicare Practice Location: 109 Danada Sq E, Wheaton, IL 60189 Phone: 331-716-4955 | |
Dr. Rasha Dhaher, Optometrist Medicare: Medicare Enrolled Practice Location: 2254 Blacksmith Dr, Wheaton, IL 60189 Phone: 630-492-7262 |