MEDICARE: DR. BRIAN LARSEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	036129978	IL
2	207W00000X	Ophthalmology Physician	54511	WI
3	207WX0107X	Retina Specialist (Ophthalmology) Physician	036129978	IL

General Provider Information

NPI Number	:	1083871974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN LARSEN M.D.

Provider Business Mailing Address
First Line	:	1S376 SUMMIT AVE STE 4C
Second Line	:
City	:	OAKBROOK TERRACE
State	:	IL
Zip	:	60181-3966
Country	:	US
Telephone Number	:	773-943-7425
Fax Number	:	773-896-0303

Provider Business Practice Location Address
First Line	:	477 E BUTTERFIELD RD STE 105
Second Line	:
City	:	LOMBARD
State	:	IL
Zip	:	60148-5622
Country	:	US
Telephone Number	:	773-943-7425
Fax Number	:	773-896-0303

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/19/2008
Last Update Date	:	07/03/2025

Similar Medicare Providers

1851126270 — RETINA CENTER OF CHICAGO PLLC
Practice Location Address:

477 E BUTTERFIELD RD STE 105
LOMBARD, IL
60148-5622

Practice Phone: 773-943-7425
Practice Fax:

1114902962 — DR. CONNIE BEA NATVIG PHD
Practice Location Address:

477 E BUTTERFIELD RD STE 107
LOMBARD, IL
60148-5622

Practice Phone: 708-955-4950
Practice Fax:

1023199320 — DR. MARILYN K STUCKEY PH.D.
Practice Location Address:

477 E BUTTERFIELD RD STE 107
LOMBARD, IL
60148-5622

Practice Phone: 630-430-8319
Practice Fax:

1104433473 — CHICAGOLAND EYE CONSULTANTS, SC
Practice Location Address:

477 E BUTTERFIELD RD STE 105
LOMBARD, IL
60148-5622

Practice Phone: 773-775-9755
Practice Fax: 630-724-1410

1750036968 — LAB WERKS INC
Practice Location Address:

477 E BUTTERFIELD RD STE 108
LOMBARD, IL
60148-5622

Practice Phone: 773-387-2476
Practice Fax:

1629909189 — BREANNE HALEY
Practice Location Address:

820 PARKVIEW BLVD
LOMBARD, IL
60148-3200

Practice Phone: 331-256-5255
Practice Fax:

Directions to “ DR. BRIAN LARSEN M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.