Provider Demographics
NPI:1679039457
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:OWNER
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:815-889-3333
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:815-889-3333
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:815-889-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-15
Last Update Date:2019-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty