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1871794362
LAKESIDE EYE CLINIC INC
CHICAGO, IL
NPI
1871794362
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Entity Type
Organization
Authorized Contact
ERNESTO CARRASCO
President
312-553-1818
Organization Subpart ?
No
Primary Taxonomy
305R00000X Preferred Provider Organization
Enumeration Date
2007-05-30
Last Update Date
2020-08-22
Business Address
LAKESIDE EYE CLINIC INC
104 S MICHIGAN AVE 410
CHICAGO, IL 60603-5902
Phone number: 312-553-1818
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Mailing Address
LAKESIDE EYE CLINIC INC
104 S MICHIGAN AVE 410
CHICAGO, IL 60603-5902
Phone number: 312-553-1818
Copy
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