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General NPI Number Information
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NPI Number | 1659984607
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Entity Type | Organization
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Legal Business Name | LASER AND CATARACT INSTITUTE, LLC
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 08/28/2020
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Provider Practice Location Address
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Address Line | 22200 WOLF RD
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City | FRANKFORT
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State | IL
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Zip | 60423-7721
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Country | US
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Telephone | 630-697-1245
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Fax |
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Provider Business Mailing Address
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Address Line | 22200 WOLF RD
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City | FRANKFORT
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State | IL
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Zip | 60423-7721
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Country | US
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Telephone | 630-697-1245
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. SAM MULTACK
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Credential | DO
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Telephone | 630-697-1245
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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