Individual provider Active NPI

Syeda Rabab Fatima, OD

  • Optometrist
  • Des Plaines, IL
National Provider Identifier
1699124602
Registry record updated Oct 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046.011011 Issued in IL
Practice address
865 Elmhurst Rd
Des Plaines, IL 60016-5605
Phone
(847) 437-1005
Fax
(847) 437-0755
NPI assigned
Jun 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046.011011 IL Primary

Addresses

Primary practice location

865 Elmhurst Rd
Des Plaines, IL 60016-5605

Mailing address

8614 Westwood Center Dr FL 9
Vienna, VA 22182-2442
Phone (703) 847-8899

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170621002703 IL Practitioner - Optometry 2466720156 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Myeyedr Optometry of Illinois LLCGroup PAC ID 3577869965, 66 clinicians

Practice addresses (Care Compare)

1114 W Devon Ave
Elk Grove Village, IL 60007-3214
Phone (847) 895-7222

5408 N Clark St
Chicago, IL 60640-1210
Phone (773) 275-2020

801 Meacham Rd
Elk Grove Village, IL 60007-3073
Phone (630) 599-7657

865 Elmhurst Rd
Des Plaines, IL 60016-5605
Phone (847) 437-1005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
046.011011ILMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Nur Vision LLC Optometrist CurrentSince Jan 1, 2026 Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist CurrentSince Oct 1, 2024 Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist CurrentSince Oct 1, 2024 Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist Past Accepting new patients

Locations

5408 N Clark St
Chicago, IL 60640
Phone (773) 275-2020

865 Elmhurst Rd
Des Plaines, IL 60016
Phone (847) 437-1005

801 Meacham Rd
Elk Grove Vlg, IL 60007
Phone (847) 584-7082

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729123200000",
    "number": "1699124602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8614 WESTWOOD CENTER DR FL 9",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221822442",
            "telephone_number": "703-847-8899",
            "fax_number": "571-223-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "865 ELMHURST RD",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600165605",
            "telephone_number": "847-437-1005",
            "fax_number": "847-437-0755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FATIMA",
        "first_name": "SYEDA",
        "middle_name": "RABAB",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046.011011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Plaines, IL

Sources for this page

Verify at the official NPI Registry.