Individual provider Active NPI

Sabrina D'Haiti, OD

  • Optometrist
  • Evanston, IL
National Provider Identifier
1033725114
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.011473 Issued in IL
Practice address
635 Chicago Ave
Evanston, IL 60202-2365
Phone
(847) 864-8209
NPI assigned
Sep 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.011473 IL Primary

Addresses

Primary practice location

635 Chicago Ave
Evanston, IL 60202-2365

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970
Phone (703) 847-8899

Other practice location 1

55 E Main St
Roselle, IL 60172-2076
Phone (630) 529-0993

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210330001543 IL Practitioner - Optometry 9537576046 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Illinois LLCGroup PAC ID 3577869965, 66 clinicians

Practice addresses (Care Compare)

55 E Main St
Roselle, IL 60172-2076
Phone (630) 529-0993

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.011473ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Illinois, LLC Optometrist CurrentSince Apr 12, 2021 Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist CurrentSince Apr 12, 2021 Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist Past Accepting new patients

Locations

5408 N Clark St
Chicago, IL 60640
Phone (773) 275-2020

3627 N Western Ave
Chicago, IL 60618
Phone (773) 525-2022

1114 W Devon Ave
Elk Grove Village, IL 60007
Phone (847) 895-7222

138 N York St
Elmhurst, IL 60126
Phone (630) 279-2020

146 Center St
Ste 200
Grayslake, IL 60030
Phone (773) 736-6800

950 W State Route 22
Lake Zurich, IL 60047
Phone (847) 726-2020

55 E Main St
Roselle, IL 60172
Phone (630) 529-0993

1979 Huntley Rd
West Dundee, IL 60118
Phone (847) 836-2020

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Interoperability endpoints

  • Direct secure messaging: sdhaiti020219@myeyedr.emadirect.md

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1600819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1033725114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 CHICAGO AVE",
            "city": "EVANSTON",
            "state": "IL",
            "postal_code": "602022365",
            "telephone_number": "847-864-8209"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 E Main St",
            "address_purpose": "LOCATION",
            "city": "Roselle",
            "state": "IL",
            "postal_code": "601722076",
            "country_code": "US",
            "telephone_number": "630-529-0993",
            "fax_number": "630-529-1220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "D'HAITI",
        "first_name": "SABRINA",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-23",
        "last_updated": "2021-03-25",
        "certification_date": "2020-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Evanston, IL

Sources for this page

Verify at the official NPI Registry.