Provider Demographics
NPI:1588292031
Name:CHICAGOLAND ADVANCED RETINA CARE LTD
Entity type:Organization
Organization Name:CHICAGOLAND ADVANCED RETINA CARE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:W
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:510-292-8058
Mailing Address - Street 1:303 W LAKE ST STE 303
Mailing Address - Street 2:
Mailing Address - City:ADDISON
Mailing Address - State:IL
Mailing Address - Zip Code:60101-2586
Mailing Address - Country:US
Mailing Address - Phone:630-225-7247
Mailing Address - Fax:619-326-3920
Practice Address - Street 1:303 W LAKE ST STE 303
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-2586
Practice Address - Country:US
Practice Address - Phone:630-225-7247
Practice Address - Fax:619-326-3920
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-31
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center