# RETINA INSTITUTE OF ILLINOIS PC

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

## Provider details

- **NPI number:** 1417037623
- **Authorized official:** CANDICE B DAVIS (CHIEF REVENUE CYCLE OFFICER)
- **Authorized official phone:** (916) 990-7590

## Contact information

- **Practice address:** 8780 W GOLF RD, SUITE 304, NILES, IL 60714-5602
- **Practice address phone:** (847) 297-8900
- **Practice address fax:** (847) 297-8926
- **Mailing address:** 8780 W GOLF RD, SUITE 304, NILES, IL 60714-5602
- **Mailing address phone:** (847) 297-8900
- **Mailing address fax:** (847) 297-8926

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | — | NULL | Yes |
| 207W00000X | Ophthalmology Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/16/2006
- **Last updated:** 06/18/2025