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General NPI Number Information
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NPI Number | 1821164039
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Entity Type | Organization
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Legal Business Name | RETINA SERVICES OF ILLINOIS, LLC
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Dates
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Enumeration Date | 11/28/2006
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Last Update Date | 08/22/2018
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Provider Practice Location Address
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Address Line | 7447 W TALCOTT AVE STE 345
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City | CHICAGO
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State | IL
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Zip | 60631
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Country | US
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Telephone | 847-972-2700
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Fax | 847-972-2712
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Provider Business Mailing Address
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Address Line | 7447 W TALCOTT AVE STE 345
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City | CHICAGO
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State | IL
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Zip | 60631-3714
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Country | US
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Telephone | 847-972-2700
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Fax | 847-972-2712
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROBERT P SCHROEDER
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Credential | MD
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Telephone | 847-972-2700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 036-068461
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License Number State | IL
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