RETINA INSTITUTE OF ILLINOIS PC – Specialist, NPI 1417037623

RETINA INSTITUTE OF ILLINOIS PC is a healthcare provider. based in Niles, Illinois. specializing in Specialist. The organization holds a License No. 036088212 (IL). The NPI Number for RETINA INSTITUTE OF ILLINOIS PC is 1417037623

Main info

Organization
Name
RETINA INSTITUTE OF ILLINOIS PC
NPI
1417037623
Phone
(847) 297-8900
Address
8780 W GOLF RD
Authorized Official
CANDICE B DAVIS CHIEF REVENUE CYCLE OFFICER
Enumeration Date
16 October 2006
Last Update Date
18 June 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness85
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for RETINA INSTITUTE OF ILLINOIS PC

  • Golf Road, Skokie, Niles Township, Cook County, Illinois, 60025, United States

    SUITE 304

    NILES, IL 607145602

    Phone: (847) 297-8900

    Fax: (847) 297-8926

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2006-12-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-08-31 (282 days ago).

Enrollment records

1

Earliest due date

2025-08-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20061205000398OClinic/Group PracticeIL2025-08-31

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60714)

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Reviews

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Frequently asked questions

Can I cross-check RETINA INSTITUTE OF ILLINOIS PC using NPI 1417037623?
NPI 1417037623 belongs to RETINA INSTITUTE OF ILLINOIS PC; compare other details if you need extra assurance.
Is RETINA INSTITUTE OF ILLINOIS PC still an active registrant?
RETINA INSTITUTE OF ILLINOIS PC carries an active NPI according to the public dataset.
What kind of doctor is RETINA INSTITUTE OF ILLINOIS PC?
RETINA INSTITUTE OF ILLINOIS PC is associated with Other Service Providers in the directory — Clinical services aligned with this taxonomy classification.
Is RETINA INSTITUTE OF ILLINOIS PC located near Niles?
RETINA INSTITUTE OF ILLINOIS PC currently maps to Niles, Illinois in this extract.
When was this NPI issued?
Enumeration for RETINA INSTITUTE OF ILLINOIS PC is noted as October 16, 2006 where the registry provides it.

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