institution
Retina Group Limited Pc
Specialist in Belleville, Illinois
NPI 1477694743

Retina Group Limited Pc is a Specialist based in Saint Louis, IL. Retina Group Limited Pc practices in Belleville, IL. The NPI Number for Retina Group Limited Pc is 1477694743 and holds a License No. 036-094928 (Illinois).

The current practice location address for Retina Group Limited Pc is 4550 Memorial Dr Ste 350, Belleville, IL and can be reached out via phone at 618-632-8100 and via fax at 618-632-8101.

Location: 4550 Memorial Dr Ste 350, Belleville, IL, 63150-0001
institution
Provider Profile Details
NPI Number
1477694743
Provider Name
Retina Group Limited Pc
Credential
Provider Entity Type
Organization
Address
4550 Memorial Dr Ste 350, Belleville, IL, 63150-0001
Phone Number
618-632-8100
Fax Number
618-632-8101
Provider Enumeration Date
02/09/2007
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
5234019 01 MO AETNA MO
06030124 01 IL BCBSIL
143209 01 MO BCBSMO
3411178005 01 IL CIGNA IL
3411178005 01 MO CIGNA MO
000000012366 01 IL ESSENCE
10585 01 IL GHP IL
CB6939 01 MO RRMCRMO GROUP ID
008257 01 MO EXCLUSIVE CHOICE MO
000000012366 01 MO ESSENCE MO
213418 01 IL PTAN
CB6940 01 IL RRMCRIL GROUP ID
000015461 01 MO PTAN
10585 01 MO GHP MO
255484 01 MO HEALTHLINK MO
255484 01 IL HLTHLNK
008257 01 IL EXCLU CHOICE IL
5234019 01 IL AETNA IL
institution
Provider Business Practice Location Address Details
Address
4550 Memorial Dr Ste 350
City
State
Zip
62226-5372
Phone Number
618-632-8100
Fax Number
618-632-8101
person
Provider Business Mailing Address Details
Address
4550 Memorial Dr Ste 350
City
State
Zip
62226-5372
Phone Number
618-632-8100
Fax Number
618-632-8101
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
License No.
036-094928 (Illinois)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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