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General NPI Number Information
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NPI Number | 1245429679
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Entity Type | Organization
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Legal Business Name | LARRY A. AUERBACH, M.D., P.C.
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Dates
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Enumeration Date | 10/22/2007
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Last Update Date | 02/29/2024
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Provider Practice Location Address
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Address Line | 1634 W POLK ST
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City | CHICAGO
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State | IL
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Zip | 60612-4352
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Country | US
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Telephone | 847-436-8300
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Fax | 847-487-7571
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Provider Business Mailing Address
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Address Line | 2574 PORTAGE AVE
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City | WAUCONDA
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State | IL
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Zip | 60084-5031
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Country | US
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Telephone | 847-436-8300
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Fax | 847-436-8300
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LARRY ALAN AUERBACH
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Credential | MD
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Telephone | 847-436-8300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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