| NPI | 1851126270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN LARSEN President 773-943-7425 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology |
| Additional Taxonomies | 207WX0107X Ophthalmology, Retina Specialist |
| Enumeration Date | 2024-09-05 |
| Last Update Date | 2025-07-30 |