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NPI Code Detail

MEDICARE: RETINA ASSOCIATES LTD

MEDICARE: RETINA ASSOCIATES LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207WX0107XRetina Specialist (Ophthalmology) Physician
2207W00000XOphthalmology Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CD1803OTHERILRR MEDICARE
3CM7388OTHERILRR MEDICARE GROUP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
22201714OTHERILGROUP BCBS OF IL

General Provider Information

NPI Number : 1629067673
Entity Type Code : Organization
Provider Name (Legal Business Name) : RETINA ASSOCIATES LTD
Provider Business Mailing Address
First Line : 133 E BRUSH HILL RD STE 300
Second Line :
City : ELMHURST
State : IL
Zip : 60126-5659
Country : US
Telephone Number : 630-571-1501
Fax Number : 630-571-5679
Provider Business Practice Location Address
First Line : 133 E BRUSH HILL RD STE 300
Second Line :
City : ELMHURST
State : IL
Zip : 60126-5659
Country : US
Telephone Number : 630-571-1501
Fax Number : 630-571-5679
Authorized Official
Title or Position : PRESIDENT
Name : DR. AARON B WEINBERG
Credential : M.D.
Telephone Number : 630-571-1501
Provider Enumeration Date : 10/20/2005
Last Update Date : 06/06/2024

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Directions to “RETINA ASSOCIATES LTD ” Practice Location

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