Organization
MODERN EYE CAER LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEKSANDR KAGAN D.O. (PHYSICIAN)
(773) 564-6175
Entity
Organization
Contact information
Practice address
4640 N MARINE DR, 8 BLUM, CHICAGO, IL 60640-5719
(773) 564-6175
(773) 561-0631
Mailing address
4640 N MARINE DR, CHICAGO, IL 60640-5719
(773) 564-6175
(773) 561-0631
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1598728453
INDIVIDUAL NPI
—
Enumeration date
11/02/2007
Last updated
12/20/2007
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