Organization
CHICAGO LASIK CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN STEPHAN MCGLOTHAN MD (MANAGING MEMBER/MEDICAL DIRECTOR)
(317) 267-9014
Entity
Organization
Contact information
Practice address
405 N WABASH AVE STE P-2E, CHICAGO, IL 60611-3591
(708) 536-8078
Mailing address
405 N WABASH AVE STE P2E, CHICAGO, IL 60611-3591
(312) 955-0072
Taxonomy
Speciality
Code
Description
License number
State
261QS0132X
Ophthalmologic Surgery Clinic/Center
Primary
—
—
Other
Enumeration date
09/13/2018
Last updated
06/13/2019
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