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ILLINOIS RETINA ASSOCIATES PLLC NPI 1225038870


NPI Information

NPI: 1225038870
Provider Name: ILLINOIS RETINA ASSOCIATES PLLC

Doing Business As: THE RETINA CENTER

Classification: Ophthalmology - 207WX0107X
Entity Type: Organization

Specialization: Retina Specialist

CLIA Number: 14D2180040

Address:
71 W 156TH ST
STE 400
HARVEY, IL
ZIP 60426
Phone: (708) 596-8710
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ILLINOIS RETINA ASSOCIATES PLLC is a retina specialist ophthalmology in Harvey, IL. The provider is an ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. ILLINOIS RETINA ASSOCIATES PLLC NPI is 1225038870. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As The Retina Center.

The provider's business location address is:

71 W 156TH ST
STE 400
HARVEY, IL
ZIP 60426-265
Phone: (708) 596-8710
Fax: (708) 596-9820

The provider's authorized official is Mary Frederick .
The authorized official title is Billing Manager and has the following contact phone number (708) 915-6963.

The CLIA number assigned to this NPI record is 14D2180040 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/26/2005 and was last updated on 12/9/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207W00000XOphthalmology036113707ILLINOISNo
2207WX0107XOphthalmologyRetina SpecialistYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1CN0205OTHERINDIANARAILROAD MEDICARE
2CN1137OTHERILLINOISRAILROAD MEDICARE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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