Individual
DR. BRIAN LARSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
477 E BUTTERFIELD RD STE 105, LOMBARD, IL 60148-5622
(773) 943-7425
(773) 896-0303
Mailing address
1S376 SUMMIT AVE STE 4C, OAKBROOK TERRACE, IL 60181-3966
(773) 943-7425
(773) 896-0303
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036129978
IL
207W00000X
Ophthalmology Physician
54511
WI
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
036129978
IL
Other
Enumeration date
05/19/2008
Last updated
07/03/2025
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