Active NPI
Advanced Retinal Institute, Inc.
- Ophthalmology Physician
- Palos Heights, IL
National Provider Identifier
1760666754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 036111343
- Legal business name
- ADVANCED RETINAL INSTITUTE, INC.
- Practice address
- 7808 W College Dr
1NW
Palos Heights, IL 60463-1027 - Phone
- (708) 499-0123
- Fax
- (708) 499-0611
- NPI assigned
- Dec 26, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Calvin Alexander Grant
- Title
- President
- Phone
- (708) 499-0123
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 036111343 | IL | Primary |
Addresses
Primary practice location
7808 W College Dr
1NW
Palos Heights, IL 60463-1027
Mailing address
7808 W College Dr
1NW
Palos Heights, IL 60463-1027
Phone (708) 499-0123
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036111343 | Medicaid | IL | |
| 216010 | Other | IL | PTAN |
| 217046046 | Medicaid | IL | |
| 1760666754 | Other | IL | NPI |
National Provider Directory
National Provider DirectoryLocations
3335 N Arlington Heights Rd
Ste A
Arlington Heights, IL 60004
Phone (847) 222-7554
8541 S State St
Ste 4
Chicago, IL 60619
Phone (708) 499-0123
9730 S Western Ave
Ste 704
Evergreen Park, IL 60805
Phone (708) 499-0123
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Ophthalmology Physician
- Garland, TX
- NPI 1164478962
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1198627200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1278460800000",
"number": "1760666754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7808 W COLLEGE DR",
"address_2": "1NW",
"city": "PALOS HEIGHTS",
"state": "IL",
"postal_code": "604631027",
"telephone_number": "708-499-0123",
"fax_number": "708-499-0611"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7808 W COLLEGE DR",
"address_2": "1NW",
"city": "PALOS HEIGHTS",
"state": "IL",
"postal_code": "604631027",
"telephone_number": "708-499-0123",
"fax_number": "708-499-0611"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANCED RETINAL INSTITUTE, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2007-12-26",
"last_updated": "2010-07-07",
"status": "A",
"authorized_official_last_name": "GRANT",
"authorized_official_first_name": "CALVIN",
"authorized_official_middle_name": "ALEXANDER",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "708-499-0123",
"authorized_official_name_prefix": "Dr."
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Ophthalmology",
"state": "IL",
"license": "036111343",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036111343",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PTAN",
"identifier": "216010",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "217046046",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NPI",
"identifier": "1760666754",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Palos Heights, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.