Organization
LEONID AYZENBERG, M.D. INC
Active
Other names
Eye Clinic Leonid Ayzenberg MD INC
Organization subpart
No
Provider details
NPI number
Authorized official
LEONID AYZENBERG (PRESIDENT/OWNER)
(847) 537-6800
Entity
Organization
Contact information
Practice address
303 E. RAND RD, MT PROSPECT, IL 60056-1508
(847) 537-6800
(847) 556-8847
Mailing address
303 E. RAND RD, MT PROSPECT, IL 60056-1508
(847) 537-6800
(847) 556-8847
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036095153
—
IL
01
—
1622332
BS & BS PROVIDER NUMBER
IL
01
—
=========
TAX ID
IL
Enumeration date
12/27/2006
Last updated
04/26/2022
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