Chicago Retina, Incorporated

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

036097549 Issued in IL

Legal business name

CHICAGO RETINA, INCORPORATED

Practice address

1182 N Milwaukee Ave
Storefront
Chicago, IL 60642-4007

Phone

(773) 394-6990

Fax

(773) 394-6993

NPI assigned

Oct 11, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Carol A Menner, M.D.NPI 1922019181

Title

President

Phone

(773) 394-6990

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Carol A. Menner, M.D.

  • Ophthalmology Physician
  • Chicago, IL
  • NPI 1922019181
  Medicare reassignment Care Compare group NPD Authorized official
• Neerav Neel Lamba, M.D.

  • Ophthalmology Physician
  • Oak Brook, IL
  • NPI 1396030094
  Medicare reassignment Care Compare group NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1223683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223683200000",
    "number": "1619129491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1182 N MILWAUKEE AVE",
            "address_2": "STOREFRONT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606424007",
            "telephone_number": "773-394-6990",
            "fax_number": "773-394-6993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1182 N MILWAUKEE AVE",
            "address_2": "STOREFRONT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606424007",
            "telephone_number": "773-394-6990",
            "fax_number": "773-394-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO RETINA, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-11",
        "last_updated": "2008-10-11",
        "status": "A",
        "authorized_official_last_name": "MENNER",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-394-6990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "IL",
            "license": "036097549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chicago Reach Foundation
• Chicago Regenerative Medical Center Corporation
• Chicago Rehabilitation Services Inc
• Chicago Rehabilitation Specialists,
• Chicago Research Center
• Chicago Rheumatology and Medical Clinic, S.C.
• Chicago Safe Ride LLC
• Chicago Sinus & Allergy Center
• Chicago Skin Solutions, Inc.
• Chicago Sleep Disorders Center

• Ophthalmology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Ophthalmology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.