Individual provider Active NPI

Ammar Jawdi, O.D.

  • Optometrist
  • Oak Lawn, IL
National Provider Identifier
1922457068
Registry record updated Apr 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
046010990 Issued in IL
Practice address
10550 S Cicero Ave
Oak Lawn, IL 60453-5597
Phone
(708) 499-3911
Fax
(708) 424-5318
NPI assigned
Jun 9, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 046010990 IL Primary

Addresses

Primary practice location

10550 S Cicero Ave
Oak Lawn, IL 60453-5597

Mailing address

1950 Old Gallows Rd Ste 520
Vienna, VA 22182-3970

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
I20171107001602 IL Practitioner - Optometry 9335405398 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
Illinois College of Optometry at Chicago, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myeyedr Optometry of Illinois LLCGroup PAC ID 3577869965, 66 clinicians

Practice addresses (Care Compare)

10550 S Cicero Ave
Oak Lawn, IL 60453-5597
Phone (708) 499-3911

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Myeyedr Optometry of Illinois, LLC Optometrist Current Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist CurrentSince Sep 19, 2017 Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist CurrentSince Sep 19, 2017 Accepting new patients
Myeyedr Optometry of Illinois, LLC Optometrist Past Accepting new patients

Locations

310 S Weber Rd
Bolingbrook, IL 60490
Phone (630) 771-0600

585 River Oaks W
Calumet City, IL 60409
Phone (219) 924-9714

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

370 Houbolt Rd
Ste 102
Joliet, IL 60431
Phone (815) 729-9143

3224 Ridge Rd
Ste 102
Lansing, IL 60438
Phone (708) 895-4422

106 Ridge Rd
Ste 112
Minooka, IL 60447
Phone (815) 467-7090

10550 S Cicero Ave
Oak Lawn, IL 60453
Phone (708) 499-3911

8614 Westwood Center Dr
Fl 9
Vienna, VA 22182

1950 Old Gallows Rd
Ste 520
Vienna, VA 22182

Organizations & group practices 4

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": "1649376000000",
    "number": "1922457068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1950 OLD GALLOWS RD STE 520",
            "city": "VIENNA",
            "state": "VA",
            "postal_code": "221823970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10550 S CICERO AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535597",
            "telephone_number": "708-499-3911",
            "fax_number": "708-424-5318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAWDI",
        "first_name": "AMMAR",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-09",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "IL",
            "license": "046010990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Lawn, IL

Sources for this page

Verify at the official NPI Registry.