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Organization

LASER MD SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOSE M RODRIGUEZ MD (PROVIDER)
(773) 531-9435
Entity
Organization

Contact information

Practice address
1449 W FLETCHER ST, STE 3, CHICAGO, IL 60657-2112
(773) 531-9435
Mailing address
1449 W FLETCHER ST, STE 3, CHICAGO, IL 60657-2112
(773) 531-9435

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036089962
IL

Other

Enumeration date
09/08/2010
Last updated
09/08/2010
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