Eiman Yousif Gafour, O.D

Primary specialty

OptometristTaxonomy code 152W00000X

License

046009572 Issued in IL

Practice address

12812 Western Ave
Blue Island, IL 60406-2118

Phone

(708) 385-0013

Fax

(708) 385-1175

NPI assigned

Aug 2, 2006

Last updated

Feb 21, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prism Eye Care, Inc.Group PAC ID 1557469343, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Prism Eye Care, Inc.

  • Optometrist
  • Chicago, IL
  • NPI 1649482258
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392940800000",
    "number": "1043227168",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3448 N MONTICELLO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185356",
            "telephone_number": "312-342-7007",
            "fax_number": "708-552-9017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12812 WESTERN AVE",
            "city": "BLUE ISLAND",
            "state": "IL",
            "postal_code": "604062118",
            "telephone_number": "708-385-0013",
            "fax_number": "708-385-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAFOUR",
        "first_name": "EIMAN",
        "middle_name": "YOUSIF",
        "credential": "O.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-02",
        "last_updated": "2014-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046009572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCR",
            "identifier": "P00178341",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046009572",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Daniel James Fitzgerald, M.D.
• Darryl J. Fleishman, M.D.
• Nicole Frazier
• Kaitlyn Alexandria Freidhof
• Mikhail Freidine, MD
• Joaquin Galvan, CRNA
• Karla Garner
• Geo Allen Shoes Inc (George Allen Shoes Inc)
• Ehab Taher Awadi Ghandour, DMD
• Nicholas J Gierman, ATC

• Optometrist in Blue Island, IL
• Providers in Blue Island, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.