Kelly Nora Djoum, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

046.011407 Issued in IL

Practice address

7225 N Caldwell Ave
Niles, IL 60714-4548

Phone

(847) 647-0707

NPI assigned

Jul 14, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Illinois College of Optometry at Chicago, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Professional Eye Care Center, Inc.Group PAC ID 6002702883, 3 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Professional Eye Care Center, Inc.

  • Optometrist
  • Niles, IL
  • NPI 1720171515
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594684800000",
    "number": "1669080826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7225 N CALDWELL AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607144548",
            "telephone_number": "847-647-0707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7225 N CALDWELL AVE",
            "city": "NILES",
            "state": "IL",
            "postal_code": "607144548",
            "telephone_number": "847-647-0707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJOUM",
        "first_name": "KELLY",
        "middle_name": "NORA",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011407",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diamond Plus Orthodontics by Bubon Orthodontics
• Karen C Dilfer, OTR
• Christopher Joseph Dimaano, DPT
• Discount Smile Group, Inc
• Lisa Ann Ditchek, PSYD
• Dma Nutriton Inc
• Margaret Marie Dolan, M.D.
• Ira J Dolnick, D.D.S.
• Eugene Donchev Donchev, CSA
• Mary A Dougal, MD

• Optometrist in Niles, IL
• Providers in Niles, IL by specialty
• Optometrist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; 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.

Verify at the official NPI Registry.