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Individual

LAWRENCE M KAUFMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

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
036-074319
IL
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
Primary
036074319
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036074319
IL
01
31603018
BLUE CROSS ID
Enumeration date
05/05/2006
Last updated
10/12/2018
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