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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 Specialty Code Provider Type

Ophthalmic Plastic and Reconstructive Surgery

207WX0200X 18 Physician/Ophthalmology
 

Ophthalmology

207W00000X 18 Physician/Ophthalmology
Indicates primary specialty

NPI Profile & details for TAMARA R FOUNTAIN · (Female)

NPI # 1033110978
Status Active
Credentials MD
Entity Individual
Enumeration date 08/02/2005
Last updated 06/03/2016 - About 10 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036-085597
  • IL License # 036085597
  • IL Medicaid 036085597
  • Other 180042658 RAILROAD MEDICARE
Hospital affiliation(s)
  • EVANSTON HOSPITAL - (Acute Care)
    2650 RIDGE AVE
    EVANSTON, IL 60201
  • RUSH UNIVERSITY MEDICAL CENTER - (Acute Care)
    1653 WEST CONGRESS PARKWAY
    CHICAGO, IL 60612
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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