Organization Active NPI

Ameera Sulakhe, O.D. Inc.

  • Optometrist
  • Chicago, IL
National Provider Identifier
1770109787
Registry record updated Jun 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
AMEERA SULAKHE, O.D. INC.
Practice address
5315 W Devon Ave
Chicago, IL 60646-4102
Phone
(773) 775-6555
NPI assigned
Jun 25, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2020

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

Authorized official

Name
Dr. Ameera Sulakhe, ODNPI 1619330263
Title
Optometrist
Phone
(773) 775-6555

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 Primary

Addresses

Primary practice location

5315 W Devon Ave
Chicago, IL 60646-4102

Mailing address

5315 W Devon Ave
Chicago, IL 60646-4102

Other names 1

  • Edgebrook Vision Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200716001363 IL Part B Supplier - Clinic/Group Practice 1951725530 Receives reassigned benefits from 1 practitioner
Practice locations: Chicago, 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": "1593043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593043200000",
    "number": "1770109787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5315 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5315 W DEVON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606464102",
            "telephone_number": "773-775-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMEERA SULAKHE, O.D. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-25",
        "last_updated": "2020-06-25",
        "certification_date": "2020-06-25",
        "status": "A",
        "authorized_official_last_name": "SULAKHE",
        "authorized_official_first_name": "AMEERA",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "773-775-6555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Edgebrook Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jun 25, 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.