# SUBURBAN RETINA LTD

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

## Provider details

- **NPI number:** 1710033352
- **Authorized official:** SUSAN G VIERLING M.D. (OWNER)
- **Authorized official phone:** (630) 424-9877

## Contact information

- **Practice address:** 130 S MAIN ST, STE 303, LOMBARD, IL 60148-2670
- **Practice address phone:** (630) 424-9877
- **Practice address fax:** (630) 424-9878
- **Mailing address:** 130 S MAIN ST, STE 303, LOMBARD, IL 60148-2670
- **Mailing address phone:** (630) 424-9877
- **Mailing address fax:** (630) 424-9878

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207W00000X | Ophthalmology Physician | 036-091886 | IL | Yes |

## Other

- **Enumeration date:** 01/26/2007
- **Last updated:** 03/27/2017