DR. TAMARA R FOUNTAIN (NPI# 1033110978) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033110978 |
| Entity Type | Individual |
| Full Name | DR. TAMARA R FOUNTAIN |
| Credential | M.D. |
| Practice Address |
740 Waukegan Rd Suite 360 Deerfield IL 60015-4374 |
| Practice Telephone | 8479456770 |
| Practice Fax Number | 8479453159 |
| Mailing Telephone | 8479456770 |
| Mailing Fax Number | 8479453159 |
| Enumeration Date | 2005-08-02 |
| Last Update Date | 2016-06-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | 036-085597 | IL | Allopathic & Osteopathic Physicians |
| Y | 207WX0200X |
Ophthalmology Specialization: Ophthalmic Plastic and Reconstructive Surgery |
036085597 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RAILROAD MEDICARE | 180042658 | 01 | |
| IL | 036085597 | 05 |
| Street Address |
740 WAUKEGAN RD SUITE 360 |
| City | DEERFIELD |
| State | IL |
| Zip Code | 60015-4374 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447250949 | Ronald Charles May | Ophthalmology | 740 Waukegan Rd, Suite 360, Deerfield, IL 60015 | 2005-07-26 |
| 1750423463 | Ophthalmology Partners, Ltd. | Ophthalmology | 740 Waukegan Rd, Suite 360, Deerfield, IL 60015-4374 | 2007-02-12 |
| 1104991231 | Matthew S. Plofsky | Family Medicine | 740 Waukegan Rd, Suite 300, Deerfield, IL 60015-4374 | 2006-11-22 |
| 1124054937 | Diany Morales | Ophthalmology | 740 Waukegan Rd, Suite 360, Deerfield, IL 60015-4374 | 2006-06-23 |
| 1376543041 | Mitchell L Warren | Ophthalmology | 740 Waukegan Rd, Suite 360, Deerfield, IL 60015 | 2005-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467073569 | Steven A Ditgen | Physical Therapist | 43 N. Waukegan Road, Deerfield, IL 60015 | 2020-04-29 |
| 1760017255 | Amanda Barkley | Pharmacist | 200 Wilmont Rd, Deerfield, IL 60015 | 2020-03-05 |
| 1467001487 | Nora Fahmi | Pharmacist | Walgreen Co., 200 Wilmot Road, Deerfield, IL 60015 | 2019-09-11 |
| 1477105187 | Anthony Greis | Obstetrics & Gynecology | 540 Lake Cook Road, Suite 300, Deerfield, IL 60015 | 2019-07-12 |
| 1528628484 | Cynthia Lynne Mckinzie | Psychologist | The Neuroscience Center, 440 Lake Cook Road, Deerfield, IL 60015 | 2019-06-13 |
| 1073084497 | Mary Jeane Jeane Velez | Nurse Practitioner | Brentwood Rehabilitation Center, 3705 Deerfield Rd., Deerfield, IL 60015 | 2018-12-11 |
| 1891264644 | Smile On of North Shore, PC | Dentist | 707 Lake Cook Rd., Suite 121, Deerfield, IL 60015 | 2018-11-21 |
| 1497236376 | Linda Li | Counselor | 15 Parkway North Blvd, Deerfield, IL 60015 | 2018-08-28 |
| 1174009831 | Rachael Michelle Lynn | Physician Assistant | 1302 Hazel Ave, Deerfield, IL 60015 | 2018-07-16 |
| 1730675182 | Alexandra Lee Joseph | Social Worker | 420 Lake Cook Road, Suite 113, Deerfield, IL 60015 | 2018-07-09 |
| Find all providers in zip 60015 | ||||
| Taxonomy Code | 207WX0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Ophthalmic Plastic and Reconstructive Surgery |
| A physician who specializes in oculofacial plastic and reconstructive surgery. This subspecialty combines orbital and periocular surgery with facial plastic surgery, and includes aesthetic and reconstructive surgery of the face, orbit, eyelid, and lacrimal system. Practitioners evaluate, diagnose and treat conditions involving the eyelids, brows, midface, orbits, lacrimal systems and surrounding and supporting structures of the face and neck. |
| Notes: Source: American Academy of Ophthalmology, 2015. www.aao.org [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003131657 | Paul Owen Phelps | Ophthalmology | 2050 Pfingsten Rd Ste 280, Glenview, IL 60026-1324 | 2010-04-06 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.