Individual provider Active NPI

Sheridan Lam, M.D.

  • Ophthalmology Physician
  • Lombard, IL
National Provider Identifier
1689673964
Registry record updated May 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036071526 Issued in IL
Practice address
2500 S Highland Ave
Suite 110
Lombard, IL 60148-5363
Phone
(630) 495-2220
Fax
(630) 495-2279
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 036071526 IL Primary

Addresses

Primary practice location

2500 S Highland Ave
Suite 110
Lombard, IL 60148-5363

Mailing address

2500 S Highland Avenue
Suite 110
Lombard, IL 60148-5381
Phone (630) 495-2220

Other identifiers 1

IdentifierTypeStateIssuer
036071526MedicaidIL

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060619000123 IL Practitioner - Ophthalmology 6608887740 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Northwestern University Feinberg Medical School, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dupage OphthalmologyGroup PAC ID 0345251484, 3 clinicians

Practice addresses (Care Compare)

2500 S Highland Ave
Suite 110
Lombard, IL 60148-5381
Phone (630) 495-2220

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036071526ILMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dupage Ophthalmology Ophthalmology CurrentSince Jul 1, 2006 Accepting new patients

Locations

2500 S Highland Ave
Lombard, IL 60148
Phone (630) 416-7150

2500 S Highland Ave
Ste 110
Lombard, IL 60148
Phone (630) 495-2220

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273708800000",
    "number": "1689673964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 S HIGHLAND AVENUE",
            "address_2": "SUITE 110",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601485381",
            "telephone_number": "630-495-2220",
            "fax_number": "630-495-2279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S HIGHLAND AVE",
            "address_2": "SUITE 110",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601485363",
            "telephone_number": "630-495-2220",
            "fax_number": "630-495-2279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAM",
        "first_name": "SHERIDAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2010-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036071526",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036071526",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lombard, IL

Sources for this page

Verify at the official NPI Registry.