Organization
LAWRENCE M KAUFMAN, M.D., PH.D., SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LAWRENCE MATHEW KAUFMAN M.D.,PH.D. (OWNER)
(773) 235-2020
Entity
Organization
Contact information
Practice address
2456 N WESTERN AVE, CHICAGO, IL 60647-2012
(773) 235-2020
(773) 235-2037
Mailing address
2456 N WESTERN AVE, CHICAGO, IL 60647-2012
(773) 235-2020
(773) 235-2037
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
—
—
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036074319
—
IL
05
—
1407019524
—
IL
01
—
31603018
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/21/2010
Last updated
10/12/2018
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