# RETINA CONSULTANTS OF CENTRAL ILLINOIS, SC

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

## Provider details

- **NPI number:** 1689601940
- **Authorized official:** MR. CHITTARANJAN V. REDDY MD (OWNER)
- **Authorized official phone:** (309) 693-2249

## Contact information

- **Practice address:** 3310 WEST CHARTWELL ROAD, SUITE 101, PEORIA, IL 61614
- **Practice address phone:** (309) 693-2249
- **Practice address fax:** (309) 693-2583
- **Mailing address:** PO BOX 1466, BROOKFIELD, WI 53008-1466
- **Mailing address phone:** (262) 788-9229
- **Mailing address fax:** (262) 788-9241

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 036090651 | IL | — |
| 207W00000X | Ophthalmology Physician | 042-616854 | IL | Yes |

## Other

- **Enumeration date:** 06/26/2006
- **Last updated:** 08/21/2018