Individual provider Active NPI

Tiffani Djordjevic, OD

  • Optometrist
  • Chicago, IL
National Provider Identifier
1255149258
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.011958 Issued in IL
Practice address
2736 N Clark St
Chicago, IL 60614-1503
Phone
(773) 248-8866
NPI assigned
Dec 21, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.011958 IL Primary

Addresses

Primary practice location

2736 N Clark St
Chicago, IL 60614-1503

Mailing address

2736 N Clark St
Chicago, IL 60614-1503

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
I20260323000410 IL Practitioner - Optometry 7214411834 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

833 N Clark St
Unit 514
Chicago, IL 60610-3383

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.011958ILMDOptometrist

Organizations & group practices 1

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": "1734739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1255149258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2736 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2736 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141503",
            "telephone_number": "773-248-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJORDJEVIC",
        "first_name": "TIFFANI",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-12-21",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.