Healthcare Provider Details

I. General information

NPI: 1629067673
Provider Name (Legal Business Name): RETINA ASSOCIATES LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/20/2005
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

133 E BRUSH HILL RD STE 300
ELMHURST IL
60126-5659
US

IV. Provider business mailing address

133 E BRUSH HILL RD STE 300
ELMHURST IL
60126-5659
US

V. Phone/Fax

Practice location:
  • Phone: 630-571-1501
  • Fax: 630-571-5679
Mailing address:
  • Phone: 630-571-1501
  • Fax: 630-571-5679

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207WX0107X
TaxonomyRetina Specialist (Ophthalmology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. AARON B WEINBERG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 630-571-1501