Provider Demographics
NPI:1952793739
Name:RETINA CARE, LLC
Entity Type:Organization
Organization Name:RETINA CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLNG MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:LOURDES
Authorized Official - Middle Name:
Authorized Official - Last Name:VALENTINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-423-2077
Mailing Address - Street 1:4709 GOLF RD
Mailing Address - Street 2:SUITE 117
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1231
Mailing Address - Country:US
Mailing Address - Phone:847-423-2077
Mailing Address - Fax:847-423-2959
Practice Address - Street 1:4709 GOLF RD
Practice Address - Street 2:SUITE 117
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1231
Practice Address - Country:US
Practice Address - Phone:847-423-2077
Practice Address - Fax:847-423-2959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty