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RETINA OF ILLINOIS S.C. NPI 1588706733


NPI Information

NPI: 1588706733
Provider Name: RETINA OF ILLINOIS, S.C.
Classification: Ophthalmology - 207W00000X
Entity Type: Organization
Address:
475 BROWN BLVD
SUITE 109
BOURBONNAIS, IL
ZIP 60914
Phone: (815) 802-2090
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RETINA OF ILLINOIS, S.C. is an ophthalmology in Bourbonnais, IL. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. RETINA OF ILLINOIS, S.C. NPI is 1588706733. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

475 BROWN BLVD
SUITE 109
BOURBONNAIS, IL
ZIP 60914-325
Phone: (815) 802-2090
Fax: (815) 802-2093

The provider's authorized official is Aashish V Gandhi .
The authorized official title is President and has the following contact phone number (217) 898-7686.

The enumeration date for this NPI number is 2/13/2007 and was last updated on 7/24/2007.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207W00000XOphthalmologyILLINOISYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11518989847OTHERPHYSICIAN NPI- TYPE 1
2G49370MEDICARE UPIN

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: 4/28/2024

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