Active NPI
Fatima Haider
- Optometrist
- Yorkville, IL
National Provider Identifier
1053202994
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046012073
- Practice address
- 120 E Countryside Pkwy
Yorkville, IL 60560-1877 - Phone
- (630) 553-6166
- NPI assigned
- Jul 10, 2025
- Last updated
- Sep 8, 2026
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | NU | ||
| Optometrist | 152W00000X | 046012073 | IL | Primary |
Addresses
Primary practice location
120 E Countryside Pkwy
Yorkville, IL 60560-1877
Mailing address
120 E Countryside Pkwy
Yorkville, IL 60560-1877
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046012073 | IL | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752105600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788825600000",
"number": "1053202994",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 E COUNTRYSIDE PKWY",
"city": "YORKVILLE",
"state": "IL",
"postal_code": "605601877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 E COUNTRYSIDE PKWY",
"city": "YORKVILLE",
"state": "IL",
"postal_code": "605601877",
"telephone_number": "630-553-6166"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAIDER",
"first_name": "FATIMA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-07-10",
"last_updated": "2026-09-08",
"certification_date": "2026-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046012073",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yorkville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.