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FOREST BLUFF OPTOMETRY LLC
NPI 1104628478
Optometrist in Lake Bluff, IL

Active since March 26, 2025
207-209 N. WAUKEGAN RD, LAKE BLUFF, IL 60044(815) 501-7419 Get Directions Write a Review

NPPES record last updated: March 26, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Forest Bluff Optometry Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FOREST BLUFF OPTOMETRY LLC (NPI 1104628478) is a healthcare organization registered as an optometrist in Lake Bluff, Illinois and active in the NPI registry since March 2025. The organization lists Diana Yin, Owner/optometrist, as its authorized official.

NPPES Registry Identity

NPI1104628478
Entity TypeOrganization
Primary Taxonomy152W00000X
Legal Business NameFOREST BLUFF OPTOMETRY LLC
Location Address207-209 N. WAUKEGAN RDLake Bluff, IL 60044
Mailing Address1081 Oak Spring LnLibertyville, IL 60048-1613 · (815) 501-7419
Phone(815) 501-7419
Organization SubpartNo
Authorized OfficialDiana YinOwner/optometrist · (815) 501-7419
Enumeration DateMarch 26, 2025
NPPES CertifiedMarch 24, 2025
✔ NPI 1104628478 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
207-209 N. WAUKEGAN RD, Lake Bluff, IL 60044
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Forest Bluff Optometry Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Forest Bluff Optometry LLC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Diana Yin, OD
Optometry
NPI 1023501483
207 N WAUKEGAN RD
Lake Bluff, IL 60044
(224) 524-1011
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Forest Bluff Optometry LLC's NPI number?

The NPI number for Forest Bluff Optometry LLC is 1104628478. It was assigned to this organization in the NPPES registry on March 26, 2025.

Where is Forest Bluff Optometry LLC located?

Forest Bluff Optometry LLC is located at 207-209 N. Waukegan Rd, Lake Bluff, IL 60044. The listed phone number is (815) 501-7419.

What is Forest Bluff Optometry LLC's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Forest Bluff Optometry LLC enrolled in Medicare?

Yes. Forest Bluff Optometry LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Forest Bluff Optometry LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Optometry) reassigns their Medicare billing to Forest Bluff Optometry LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Forest Bluff Optometry LLC accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Forest Bluff Optometry LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Forest Bluff Optometry LLC was last updated on March 26, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.