Dr. Jeries Qtami & Associates Inc

Primary specialty

OptometristTaxonomy code 152W00000X

License

046010554 Issued in IL

Legal business name

DR. JERIES QTAMI & ASSOCIATES INC

Practice address

21000 Western Ave
Olympia Fields, IL 60461-1900

Phone

(708) 898-9112

Fax

(708) 283-0609

NPI assigned

Oct 6, 2016

Last updated

Mar 7, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeries Qtami, O.D.NPI 1831453950

Title

Optometrist

Phone

(708) 898-9112

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jeries Munir Qtami, O.D

  • Optometrist
  • Olympia Fields, IL
  • NPI 1831453950
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1475712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709769600000",
    "number": "1437609054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 W POLK ST STE 100-135",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606052000",
            "telephone_number": "708-898-9112",
            "fax_number": "708-283-0609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21000 WESTERN AVE",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611900",
            "telephone_number": "708-898-9112",
            "fax_number": "708-283-0609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JERIES QTAMI & ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-06",
        "last_updated": "2024-03-07",
        "certification_date": "2024-03-07",
        "status": "A",
        "authorized_official_last_name": "QTAMI",
        "authorized_official_first_name": "JERIES",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "708-898-9112",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010554",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046010554",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Olympia Fields, IL
• Providers in Olympia Fields, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.