# RETINAL VITREAL CONSULTANTS LTD

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164569380
- **Authorized official:** SHAUN T ITTIARA MD (AUTHORIZED OFFICIAL)
- **Authorized official phone:** (312) 567-2795

## Contact information

- **Practice address:** 2600 S MICHIGAN AVE, STE 212, CHICAGO, IL 60616-2859
- **Practice address phone:** (312) 567-2795
- **Practice address fax:** (800) 707-4890
- **Mailing address:** PO BOX 166516, CHICAGO, IL 60616-6516
- **Mailing address phone:** (312) 567-2795
- **Mailing address fax:** (800) 707-4890

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | NULL | — |
| 207WX0107X | Retina Specialist (Ophthalmology) Physician | — | — | — |

## Other

- **Enumeration date:** 01/30/2007
- **Last updated:** 07/05/2023