Northern Illinois Retina Ltd

LBN: Northern Illinois Retina Ltd
Northern Illinois Retina Ltd is an health care organization with primary practice located at 1235 N Mulford Rd Suite 100, Rockford IL 61107-3879. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Retina Specialist is the primary health care specialty. Northern Illinois Retina Ltd can be contacted via phone (815) 226-4990, or through Fowell, Susan M via phone (815) 226-4990.

Contact Information

Primary practice address
1235 N Mulford Rd Suite 100 Rockford IL 61107-3879
Phone: (815) 226-4990
Fax: (815) 226-9472
Website:
Map and Directions
Authorized official contact:
Name: Fowell, Susan M Doctor of Medicine (MD)
Phone: (815) 226-4990

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 042006794 Illinois
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 036073359 Illinois

Profile Details

NPI number 1942483664
LBN Legal business name Northern Illinois Retina Ltd
DBA Doing business as
Authorized official Fowell, Susan M Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Dec 17th, 2007
Last updated Jul 6th, 2017 - about 7 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1942483664 NPPES
Illinois Other 1942483664 NPI

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