Glaucoma Associates of Illinois LLC

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036129423 Issued in IL

Legal business name

GLAUCOMA ASSOCIATES OF ILLINOIS LLC

Practice address

695 N Perryville Rd Ste 3
Rockford, IL 61107-6225

Phone

(815) 904-6011

Fax

(815) 904-6171

NPI assigned

Nov 3, 2017

Last updated

Mar 20, 2025By 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

Azizur Rahman, MDNPI 1346212693

Title

Owner

Phone

(312) 543-6865

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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.

• Azizur Rahman, MD

  • Ophthalmology Physician
  • Rockford, IL
  • NPI 1346212693
  Medicare reassignment Authorized official
• Jaime Lynne King, O.D.

  • Optometrist
  • Rockford, IL
  • NPI 1225131428
  NPD (past)

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

{
    "created_epoch": "1509667200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742428800000",
    "number": "1720590375",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E CHESTNUT ST APT 9A",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606117376",
            "telephone_number": "630-242-6500",
            "fax_number": "815-399-5543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "695 N PERRYVILLE RD STE 3",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076225",
            "telephone_number": "815-904-6011",
            "fax_number": "815-904-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLAUCOMA ASSOCIATES OF ILLINOIS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-03",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A",
        "authorized_official_last_name": "RAHMAN",
        "authorized_official_first_name": "AZIZUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-543-6865",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036129423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01320105",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036129423",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cindy Giurgiu
• Melissa Marie Givens, MD
• Reginald A Givens, MD
• Lindsay Gjoni
• Stephen F. Gladdin, M.D.
• Tyler Glawe, PT, DPT
• Tara Glendenning, OTR/L
• Vanessa M Glendenning, FNP
• Glennetta Coleman MD and Associates, LTD
• Glenwood Center LTD

• Ophthalmology Physician in Rockford, IL
• Providers in Rockford, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.