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General NPI Number Information
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NPI Number | 1679039457
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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 | 02/15/2019
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Last Update Date | 02/15/2019
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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 | 815-889-3333
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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 | 815-889-3333
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. SAM MULTACK
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Credential | DO
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Telephone | 815-889-3333
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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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