Provider Demographics
NPI:1538545611
Name:KARIM, FATIMA (OD)
Entity type:Individual
Prefix:
First Name:FATIMA
Middle Name:
Last Name:KARIM
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 CASS AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-2204
Mailing Address - Country:US
Mailing Address - Phone:586-464-1479
Mailing Address - Fax:
Practice Address - Street 1:1 MID AMERICA PLZ STE 250
Practice Address - Street 2:
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181-4747
Practice Address - Country:US
Practice Address - Phone:630-684-0204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901005054152W00000X
FLTPOP28152W00000X
NYTUV009326152W00000X
PAOEG004061152W00000X
GAOPT003560152W00000X
IL046.010917152W00000X
WI3944-35152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist