Active NPI
Munira Moukaddem
- Optometrist
- Oak Lawn, IL
National Provider Identifier
1407631708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 046.011787
- Practice address
- 9531 S Cicero Ave
Oak Lawn, IL 60453-3136 - Phone
- (708) 423-2020
- NPI assigned
- Aug 28, 2023
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046.011787 | IL | Primary |
Addresses
Primary practice location
9531 S Cicero Ave
Oak Lawn, IL 60453-3136
Mailing address
9236 S Thomas Ave
Bridgeview, IL 60455-2162
Phone (708) 566-7960
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Optometry
- Education
- Illinois College of Optometry at Chicago, 2023
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
4000 Luxottica PL
Mason, OH 45040-8114
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046.011787 | IL | MD | Optometrist |
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": "1693180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693180800000",
"number": "1407631708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9236 S THOMAS AVE",
"city": "BRIDGEVIEW",
"state": "IL",
"postal_code": "604552162",
"telephone_number": "708-566-7960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9531 S CICERO AVE",
"city": "OAK LAWN",
"state": "IL",
"postal_code": "604533136",
"telephone_number": "708-423-2020"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOUKADDEM",
"first_name": "MUNIRA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-28",
"last_updated": "2023-08-28",
"certification_date": "2023-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "IL",
"license": "046.011787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Oak Lawn, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.