Organization Active NPI

Prism Eye Care, Inc.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1649482258
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
PRISM EYE CARE, INC.
Practice address
3448 N Monticello Ave
Chicago, IL 60618-5356
Phone
(312) 342-7007
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Eiman Gafour, O.D.NPI 1043227168
Title
President
Phone
(312) 342-7007

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X IL Primary

Addresses

Primary practice location

3448 N Monticello Ave
Chicago, IL 60618-5356

Mailing address

3448 N Monticello Ave
Chicago, IL 60618-5356
Phone (312) 342-7007

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070601000147 IL Part B Supplier - Clinic/Group Practice 1557469343 Receives reassigned benefits from 2 practitioners
Practice locations: Niles, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649482258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3448 N MONTICELLO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185356",
            "telephone_number": "312-342-7007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3448 N MONTICELLO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185356",
            "telephone_number": "312-342-7007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRISM EYE CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GAFOUR",
        "authorized_official_first_name": "EIMAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-342-7007",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.