Individual provider Active NPI

Bahram Rahmani, MD

  • Ophthalmology Physician
  • Chicago, IL
National Provider Identifier
1306832829
Registry record updated Oct 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036109049 Issued in IL
Practice address
225 East Chicago Ave.
Division of Pediatric Opthalmology
Chicago, IL 60611
Phone
(800) 543-7362
Fax
(312) 227-9411
NPI assigned
Sep 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036109049 IL Primary

Addresses

Primary practice location

225 East Chicago Ave.
Division of Pediatric Opthalmology
Chicago, IL 60611

Mailing address

225 East Chicago Ave.
Division of Pediatric Opthalmology
Chicago, IL 60611-2991
Phone (800) 543-7362

Other practice location 1

2300 N Childrens Plz
Chicago, IL 60614-3363
Phone (773) 880-3844

Other identifiers 2

IdentifierTypeStateIssuer
036109049MedicaidIL
200482610AMedicaidIN

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051116000177 IL Practitioner - Ophthalmology 0143249425 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036109049ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Nov 1, 2015 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Nov 1, 2015 Accepting new patients
Lurie Children'S Medical Group Inc Past Accepting new patients
Lurie Children'S Medical Group, LLC Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-6415

225 E Chicago Ave
#118
Chicago, IL 60611

737 N Michigan Ave
Ste 2040
Chicago, IL 60611

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": "1127174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570147200000",
    "number": "1306832829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "225 EAST CHICAGO AVE.",
            "address_2": "DIVISION OF PEDIATRIC OPTHALMOLOGY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112991",
            "telephone_number": "800-543-7362",
            "fax_number": "312-227-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "225 EAST CHICAGO AVE.",
            "address_2": "DIVISION OF PEDIATRIC OPTHALMOLOGY",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60611",
            "telephone_number": "800-543-7362",
            "fax_number": "312-227-9411"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 N Childrens Plz",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606143363",
            "country_code": "US",
            "telephone_number": "773-880-3844",
            "fax_number": "773-880-3025",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAHMANI",
        "first_name": "BAHRAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-20",
        "last_updated": "2019-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036109049",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036109049",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200482610A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.