Organization
ADVANCED RETINAL INSTITUTE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CALVIN ALEXANDER GRANT (PRESIDENT)
(708) 499-0123
Entity
Organization
Contact information
Practice address
7808 W COLLEGE DR, 1NW, PALOS HEIGHTS, IL 60463-1027
(708) 499-0123
(708) 499-0611
Mailing address
7808 W COLLEGE DR, 1NW, PALOS HEIGHTS, IL 60463-1027
(708) 499-0123
(708) 499-0611
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036111343
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036111343
—
IL
01
—
1760666754
NPI
IL
01
—
216010
PTAN
IL
05
—
217046046
—
IL
Enumeration date
12/26/2007
Last updated
07/07/2010
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