NPI 1003875436

Illinois Retina Institute, Sc

Organisation Ophthalmology Physician Peru, IL

Practice location

Address: 3602 Marquette Rd, Peru, IL 61354-1450
Phone: (815) 223-7400
Fax: (815) 223-7477
Mailing address: PO Box 36, Peru, IL 61354-0036

Authorised official

Name: Kamal Kishore
Title: President
Phone: (815) 223-7400

Registered specialties

Ophthalmology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207W00000X Licence 036100858 (IL)

Other Ophthalmology providers in Illinois →

Registry record

NPI: 1003875436
Entity type: Organization
NPI issued: 23 Mar 2006
Record last updated: 30 Oct 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.