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DR. JOHN ICHISHITA O.D.
NPI 1164854386
Optometrist in Libertyville, IL

Active since July 30, 2013PECOS Enrolled
730 N MILWAUKEE AVE, LIBERTYVILLE, IL 60048(847) 362-9900(847) 362-9936 Get Directions Write a Review

NPPES record last updated: April 25, 2025. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Dr. John Ichishita O.d. NPPES

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

DR. JOHN ICHISHITA O.D. (NPI 1164854386) is an individual optometrist in Libertyville, Illinois, licensed in Illinois (046.010675) and active in the NPI registry since July 2013. He is enrolled in Medicare PECOS, maintains a secondary practice location in Mundelein, and is a graduate of Illinois College Of Optometry At Chicago (2013).

NPPES Registry Identity

NPI1164854386
Entity TypeIndividualMale
Primary Taxonomy152W00000X
Provider Legal NameDR. JOHN ICHISHITACredential: O.D.
Location Address730 N MILWAUKEE AVELibertyville, IL 60048-1914
Mailing Address730 N Milwaukee AveLibertyville, IL 60048-1914 · (847) 362-9900 · Fax (847) 362-9936
Phone(847) 362-9900
Fax(847) 362-9936
Sole ProprietorYes
Medical School CMSIllinois College Of Optometry At ChicagoGraduated 2013
Enumeration DateJuly 30, 2013
Last NPPES UpdateApril 25, 2025
NPPES CertifiedApril 25, 2025
✔ NPI 1164854386 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in IL · 046.010675
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.
730 N MILWAUKEE AVE, Libertyville, IL 60048
Open in Google Maps ↗

Secondary Practice Location 1

Location 1824 N Il Route 83Mundelein, IL 60060-9159 · Phone (847) 362-2020

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. John Ichishita O.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID749584894
PECOS Enrollment IDI20160210000589
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

2

Medicare enrollment records show John Ichishita reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

730 North Optometry PC
Same address
Optometrist
730 N MILWAUKEE AVE
Libertyville, IL 60048
  • Reassigned Medicare billing, Illinois enrollment
  • 4 clinicians in this Medicare group
NPI 1821435660 (847) 362-9900
Accu-Vision Center Inc.
9.2 mi
Optometrist
1914 E GRAND AVE
Lindenhurst, IL 60046
  • Reassigned Medicare billing, Illinois enrollment
  • Medicare enrollment name: Accuvision Center Inc
  • 6 clinicians in this Medicare group
NPI 1477676914 (847) 356-2020

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

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient complete exam of visual system 92014
An established patient complete exam of the visual system involves a thorough check of your eyes and vision. It assesses eye health, checks for diseases, and measures your ability to see clearly at different distances. It's a routine, non-invasive procedure.
29 services29 patients
New patient complete exam of visual system 92004
A new patient complete exam of the visual system is a thorough evaluation of your eyes and vision. It checks for any potential issues and assesses overall eye health. It includes tests for visual acuity, eye movement, and light response.
23 services23 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
16 services14 patients
Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more 99212
This is a routine check-up for patients who have previously seen the doctor. During this 10-19 minute visit, the doctor will review your health status, discuss any concerns, and manage ongoing treatments or medications. It's a chance to ensure your health is on track.
15 services13 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 60048 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$137.43 typical visit price
range $59.81 – $181.38
Typical copayment $34.35 (range $14.95 – $45.34)
Most-billed visit code 99204
Established Patient
$74.38 typical visit price
range $19.15 – $147.12
Typical copayment $18.59 (range $4.78 – $36.78)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ANGELA C PAK OH O.D.
Optometrist
730 N MILWAUKEE AVE
LIBERTYVILLE, IL 60048
Lake County (847) 362-9900
DR. JODY L RICKETTS OD
Optometrist
730 N MILWAUKEE AVE
LIBERTYVILLE, IL 60048
Lake County (847) 362-9900
730 NORTH OPTOMETRY PC
Optometrist
730 N MILWAUKEE AVE
LIBERTYVILLE, IL 60048
Lake County (847) 362-9900
BRAIN-EYE EVOLUTION AT 730 NORTH
Optometrist (Vision Therapy)
730 N MILWAUKEE AVE
LIBERTYVILLE, IL 60048
Lake County (847) 362-9900

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 John Ichishita's NPI number?

The NPI number for John Ichishita is 1164854386. It was assigned to this individual provider in the NPPES registry on July 30, 2013.

Where is John Ichishita located?

John Ichishita practices at 730 N Milwaukee Ave, Libertyville, IL 60048. The listed phone number is (847) 362-9900.

What is John Ichishita's specialty?

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

Is John Ichishita enrolled in Medicare?

Yes. John Ichishita is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for John Ichishita's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Ichishita reassigns Medicare benefits to 2 organizations: 730 North Optometry PC (Libertyville, IL) and Accu-Vision Center Inc. (Lindenhurst, IL). Each 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 John Ichishita's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does John Ichishita accept?

Health plans from Ambetter Health, Anthem Blue Cross and Blue Shield, Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana and Blue Cross and Blue Shield of Montana and 9 other insurers list John Ichishita 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 John Ichishita was last updated on April 25, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.