DR. CHULA LERDVORATAVEE (O.D.) – Optometrist, NPI 1346230604

DR. CHULA LERDVORATAVEE (O.D.) is a healthcare provider. based in Montgomery, Illinois. specializing in OPTOMETRY. They hold the professional credentials O.D.. They hold a License No. 046-007841 (IL). The NPI Number for DR. CHULA LERDVORATAVEE (O.D.) is 1346230604

Main info

Female
41 Years Of Experience
Accepts Medicare Assignment
Name
DR. CHULA LERDVORATAVEE (O.D.)
NPI
1346230604
Phone
(630) 844-0908
Address
1335 DOUGLAS RD
Enumeration Date
26 October 2005
Last Update Date
21 July 2022

Doctor Profile

Medical School Name
ILLINOIS COLLEGE OF OPTOMETRY AT CHICAGO
Secondary Phone
6308440908
Graduation Year
1985 (41 years ago)
PAC ID
1557451093
Group Practice PAC ID
8123118650
Professional Enrollment ID
I20110215001169
Address ID
IL605438312OS2075XRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience74
Completeness75
Years active:20State licenses:1Digital endpointsOther names

1,715 OPTOMETRY in IL

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Provider Addresses for DR. CHULA LERDVORATAVEE (O.D.)

  • 1335, Douglas Road, Montgomery, Aurora Township, Kane County, Illinois, 60538, United States

    SUITE E

    MONTGOMERY, IL 605381634

    Phone: (630) 844-0908

    Fax: (630) 844-0677

    Type: Mailing

  • 2075 WIESBROOK RD

    OSWEGO, IL 605438312

    Phone: (630) 844-0908

    Fax: (630) 844-0677

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 15 Open Payments records for all available years, with a total value of $305.

Total Amount is formed as General ($305) + Research ($0) + Ownership ($0) = $305.

Last reported payment date: 2024-12-21 • Largest payer in this snapshot: CooperVision Inc. ($276).

Total Amount

$305

General + Research + Ownership

Payments

15

Total payment records

General Amount

$305

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-21

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2011-02-15

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110215001169IOptometryILTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60538)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8123118650View full group profile
NameSpecialtyState
O P T O M E T R YIL
O P T O M E T R YIL

Reviews

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Frequently asked questions

What identifier follows DR. CHULA LERDVORATAVEE (O.D.) across health systems?
The NPI 1346230604 uniquely identifies DR. CHULA LERDVORATAVEE (O.D.) in U.S. healthcare data.
Does the public listing show DR. CHULA LERDVORATAVEE (O.D.) as active?
DR. CHULA LERDVORATAVEE (O.D.)'s NPI record reflects an active status in NPPES.
What services align with DR. CHULA LERDVORATAVEE (O.D.)'s listing?
DR. CHULA LERDVORATAVEE (O.D.)'s public classification highlights Optometrist. Clinical services aligned with this taxonomy classification.
What city is tied to DR. CHULA LERDVORATAVEE (O.D.)?
The directory associates DR. CHULA LERDVORATAVEE (O.D.) with Montgomery, Illinois. Check all listed addresses for suites or satellite offices.
Can I export DR. CHULA LERDVORATAVEE (O.D.)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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