Individual provider Active NPI

Serene Ann Fakhoury, OD

  • Optometrist
  • Westmont, IL
National Provider Identifier
1780576702
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
18004585A Issued in IN
Practice address
409 W Ogden Ave
Westmont, IL 60559-1421
Phone
(630) 964-9800
NPI assigned
Jul 15, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 18004585A IN Primary

Addresses

Primary practice location

409 W Ogden Ave
Westmont, IL 60559-1421

Mailing address

2015 S Finley Rd
Lombard, IL 60148-4828
Phone (312) 451-5733

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
I20250813001810 IL Practitioner - Optometry 6709393077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ophthalmology Consultants of Illinois IncGroup PAC ID 1456589829, 2 clinicians

Practice addresses (Care Compare)

409 W Ogden Ave
Westmont, IL 60559-1421
Phone (630) 964-9800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
18004585AINMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Ophthalmology Consultants of Illinois, S.C. Optometrist CurrentSince Aug 1, 2025 Accepting new patients
Ophthalmology Consultants of Illinois Inc Optometrist CurrentSince Aug 1, 2025 Accepting new patients

Locations

7001 W Archer Ave
Chicago, IL 60638
Phone (773) 229-8818

12150 S Harlem Ave
Palos Heights, IL 60463
Phone (708) 361-4778

409 W Ogden Ave
Westmont, IL 60559
Phone (630) 964-9800

Interoperability endpoints

  • Direct secure messaging: sfakhoury@ophthalmologyconsultants.direct.eyemdemr.com

Organizations & group practices 2

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": "1752537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1780576702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2015 S FINLEY RD",
            "city": "LOMBARD",
            "state": "IL",
            "postal_code": "601484828",
            "telephone_number": "312-451-5733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W OGDEN AVE",
            "city": "WESTMONT",
            "state": "IL",
            "postal_code": "605591421",
            "telephone_number": "630-964-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAKHOURY",
        "first_name": "SERENE",
        "middle_name": "ANN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-15",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IN",
            "license": "18004585A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westmont, IL

Sources for this page

Verify at the official NPI Registry.