Organization
RETINA CONSULTANTS, LTD
Active
Other names
Charles M. Vygantas MD
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GINGER ESCHEVERRIA (PRACTICE ADMINISTRATOR)
(847) 299-0700
Entity
Organization
Contact information
Practice address
2454 E DEMPSTER ST, 400, DES PLAINES, IL 60016-5315
(847) 299-0700
Mailing address
2454 E DEMPSTER ST, 400, DES PLAINES, IL 60016-5315
(847) 299-0700
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
180005501
RAILROAD MEDICARE
IL
01
—
21600807
BCBS GROUP ID NUMBER
IL
01
—
4030243
AETNA
ID
Enumeration date
12/01/2006
Last updated
11/17/2008
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