ILLINOIS RETINA SURGERY LTD NPI 1255374559

NPI Information

  • NPI: 1255374559
  • Provider Name: ILLINOIS RETINA SURGERY LTD
  • Classification: Technician/Technologist - 156FX1100X
  • Specialization: Ophthalmic
  • Entity Type: Organization
  • CLIA Number: 14D2283827
  • Address: 3990 N ILLINOIS ST
    SWANSEA, IL
    ZIP 62226
  • Phone: (618) 277-1130

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NPI Details

ILLINOIS RETINA SURGERY LTD is an ophthalmic technician technologist in Swansea, IL. The provider is an ophthalmic technician/technologist assists ophthalmologists by performing ophthalmic clinical functions, including administering eye exams, administering eye medications, and instructing the patient in care and use of corrective lenses. ILLINOIS RETINA SURGERY LTD NPI is 1255374559. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3990 N ILLINOIS ST
SWANSEA, IL
ZIP 62226-919
Phone: (618) 277-1130
Fax: (618) 277-6651

The provider's authorized official is Thomas N Fleming .
The authorized official title is Owner and has the following contact phone number (618) 277-1130.

The CLIA number assigned to this NPI record is 14D2283827 - other - substance use treatment with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/14/2006 and was last updated on 12/19/2007.

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
1156FX1100XTechnician/TechnologistOphthalmicYes

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
1DG1183MEDICARE PINILLINOIS
2L83718MEDICARE PINILLINOIS
3L83719MEDICARE PINILLINOIS
4E90243MEDICARE UPINILLINOIS
5626770MEDICARE PINILLINOIS
6626820MEDICARE PINILLINOIS
7DG1182MEDICARE PINILLINOIS

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: 11/21/2025

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