National Provider Identifier Database

TAMARA R FOUNTAIN, MD – NPI #1033110978
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.


Contact Information

TAMARA R FOUNTAIN, MD
740 WAUKEGAN RD
SUITE 360
DEERFIELD, IL60015-4374
Phone: 847-945-6770
Fax: 847-945-3159
Website:
Specialty Taxonomy Code
* Ophthalmic Plastic and Reconstructive Surgery 207WX0200X
Ophthalmology 207W00000X

* Indicates primary specialty

NPI Profile & details for TAMARA R FOUNTAIN

NPI Number 1033110978
Credentials MD
Entity Individual
Enumeration date 08/02/2005
Last updated 06/03/2016 - About 10 years ago
Sole proprietor1 No
Identifiers
  • IL License #: 036-085597
  • IL License #: 036085597
  • IL Medicaid: 036085597
  • Other: 180042658 RAILROAD MEDICARE
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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