Mahmud Abdallah, OD
Individual provider Active NPI Optometrist · Alsip, IL
NPI 1417501248 · NPPES record last updated Nov 5, 2025
Key facts
- NPI
- 1417501248
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optometrist 152W00000X
- License
- 046.011717 (IL)
- Practice address
- 6195 W 115TH St Ste B
Alsip, IL 60803-5153 - Phone
- (478) 410-6951
- NPI assigned
- Jul 30, 2019
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Optometry
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
6195 W 115TH St
Suite B
Alsip, IL 60803-5153
Phone (478) 410-6951
6195 W 115TH St B
Alsip, IL 60803-5153
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251104003875 | IL | Practitioner - Optometry | 5395235840 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046.011717 | IL | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ijm Holdings LTD | Optometrist | Current |
Accepting new patients |
| National Vision Inc | Optometrist | Past |
Accepting new patients |
Locations
6195 W 115th St
Ste B
Alsip, IL 60803
Phone (478) 410-6951
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 046.011717 | IL | Yes |
Addresses
Primary practice location
6195 W 115TH St Ste B
Alsip, IL 60803-5153
Mailing address
6195 W 115TH St Ste B
Alsip, IL 60803-5153
Phone (478) 410-6951
Other providers in Alsip, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.