Ronald S Weiss MD SC
Organization Active NPI Ophthalmology Physician · Stickney, IL
NPI 1962415992 · NPPES record last updated Jun 21, 2022
Key facts
- NPI
- 1962415992
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Ophthalmology Physician 207W00000X
- Legal business name
- RONALD S WEISS MD SC
- Practice address
- 4401 Harlem Ave
Stickney, IL 60402-4250 - Phone
- (708) 788-3400
- Fax
- (708) 788-3472
- NPI assigned
- Aug 14, 2006
- Organization subpart
- No
Authorized official
- Name
- George L Neal
- Title
- Assistant Secretary
- Phone
- (469) 214-0144
Practitioners 13
-
Wendewessen Amde, M.D.
-
Emily Jacobs, MD
-
Robert Pearlman, MD
-
Saba Quraishi, M.D.
-
Ronald S Weiss, M.D.
-
Laura Calma, OD
-
Blake H Horio, MD
-
Noor Amra, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20060216000354 | IL | Part B Supplier - Clinic/Group Practice | 4385659069 |
Receives reassigned benefits from 8 practitioners Practice locations: Chicago, IL; Downers Grove, IL; Gurnee, IL; Hinsdale, IL; River Forest, IL; Stickney, IL |
National Provider Directory
Locations
3825 Highland Ave
Ste 5
Downers Grove, IL 60515
7247 LK St
River Forest, IL 60305
Phone (708) 397-8114
4401 S Harlem Ave
Stickney, IL 60402
Phone (708) 788-3400
Interoperability endpoints
- rpearlman@cecil.intellechartdirect.net
- crocken@cecil.intellechartdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Ophthalmology Physician |
207W00000X | Yes |
Addresses
Primary practice location
4401 Harlem Ave
Stickney, IL 60402-4250
Mailing address
4401 Harlem Ave
Stickney, IL 60402-4250
Phone (708) 788-3400
Other practice location 1
2719 W Peterson Ave
Chicago, IL 60659-3919
Phone (773) 561-5100
Other practice location 2
5600 W Addison St Ste 102
Chicago, IL 60634-4401
Phone (773) 561-5100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0001608470 | Other | IL | GROUP BC/BS NUMBER |
Other names
- Chicago Eye Consultants
Other providers in Stickney, IL
- Scott Robert Musil
- Prakash Chand Navni
- Raymond H Nootens
- Pershing Convalescent Home Inc.
- Claire Tobias Rocken
- Roberta Scales
- Carole Ann Schaffer
- Scott R Musil DDS
- Cristina Solis
- Stickney Public Health District
All providers in Stickney, IL · Ophthalmology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.