Provider Demographics
NPI:1659984607
Name:LASER AND CATARACT INSTITUTE, LLC
Entity Type:Organization
Organization Name:LASER AND CATARACT INSTITUTE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SAM
Authorized Official - Middle Name:
Authorized Official - Last Name:MULTACK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:630-697-1245
Mailing Address - Street 1:22200 WOLF RD
Mailing Address - Street 2:
Mailing Address - City:FRANKFORT
Mailing Address - State:IL
Mailing Address - Zip Code:60423-7721
Mailing Address - Country:US
Mailing Address - Phone:630-697-1245
Mailing Address - Fax:
Practice Address - Street 1:22200 WOLF RD
Practice Address - Street 2:
Practice Address - City:FRANKFORT
Practice Address - State:IL
Practice Address - Zip Code:60423-7721
Practice Address - Country:US
Practice Address - Phone:630-697-1245
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL042.620929OtherSTATE OF ILLINOIS