Illinois Retina Associates PLLC
NPI 1225038870ActiveOrganization· Ophthalmology, Retina Specialist· Orland Park, IL
Ophthalmology, Retina Specialist in Orland Park, Illinois, registered in NPPES in July 2005. The authorized official on file is Mary Frederick, Billing Manager. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1225038870 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jul 26, 2005 |
| Last updated in NPPES | Feb 4, 2026 |
| Certified by provider | Feb 4, 2026 |
| Reactivated | May 18, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Ophthalmology, Retina Specialist Primary | 207WX0107X | — | — |
| Ophthalmology | 207W00000X | 036113707 | IL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (IL); Part B Supplier - Clinic/Group Practice (IN) |
|---|
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