Organization Active NPI

Advanced Retinal Institute, Inc.

  • Ophthalmology Physician
  • Palos Heights, IL
National Provider Identifier
1760666754
Registry record updated Jul 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
036111343 Issued in IL
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

Updated by the provider on Jul 7, 2010

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)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
036111343MedicaidIL
216010OtherILPTAN
217046046MedicaidIL
1760666754OtherILNPI

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.