DR. BRIAN LARSEN (NPI# 1083871974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083871974 |
| Entity Type | Individual |
| Full Name | DR. BRIAN LARSEN |
| Credential | M.D. |
| Practice Address |
4401 S Harlem Ave Stickney IL 60402-4250 |
| Practice Telephone | 7087883400 |
| Practice Fax Number | 7087883472 |
| Mailing Telephone | 7087883400 |
| Mailing Fax Number | 7087883472 |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2018-01-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207W00000X | Ophthalmology | 036129978 | IL | Allopathic & Osteopathic Physicians |
| N | 207W00000X | Ophthalmology | 54511 | WI | Allopathic & Osteopathic Physicians |
| Y | 207WX0107X |
Ophthalmology Specialization: Retina Specialist |
036129978 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376990291 | Brian Larsen | Counselor | 4123 Meachem Rd, Mount Pleasant, WI 53403-3912 | 2016-05-20 |
| 1386962108 | Brian Scott Larsen | Chiropractor | 389 Nevada St., Auburn, CA 95603 | 2010-05-05 |
| 1871505966 | Brian R Larsen | Dentist | 2115 Westlake Ave, Seattle, WA 98122 | 2006-08-13 |
| 1366768533 | Brian Timothy Larsen | Internal Medicine | 610 Nw 11th St, Hermiston, OR 97838-6601 | 2010-04-13 |
| 1114140779 | Brian John Larsen | Pharmacist | 10130 S State St, Sandy, UT 84070-4118 | 2007-04-11 |
| 1700908795 | Brian M Larsen | Chiropractor | 507 Knight St, Suite B, Richland, WA 99352-4258 | 2007-04-03 |
| 1205993961 | Brian Therald Larsen | Physical Therapist | 1300 N 500 E, Logan, UT 84341-2408 | 2007-01-02 |
| 1538129697 | Brian D. Larsen | Internal Medicine | 800 E 28th St, Mr 11326, Minneapolis, MN 55407-3723 | 2006-03-24 |
| 1790776383 | Brian K Larsen | Anesthesiology | 700 West Ave S, La Crosse, WI 54601-4783 | 2005-11-02 |
| Street Address |
4401 S HARLEM AVE |
| City | STICKNEY |
| State | IL |
| Zip Code | 60402-4250 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689687790 | Raymond H Nootens | Ophthalmology | 4401 S Harlem Ave, Stickney, IL 60402-4250 | 2006-08-14 |
| 1730743519 | Alyssa Marie Berry | Optometrist | 4401 S Harlem Ave, Stickney, IL 60402-4250 | 2019-04-26 |
| 1699158949 | Kinzy Kanisha Frizzle | Optometrist | 4401 S Harlem Ave, Stickney, IL 60402-4250 | 2015-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619586518 | Lisa K Anderson-shaw | Clinical Ethicist | Macneal Trinity Medical Cetner, 3249 Oak Park Avenue, Berwyn, IL 60402 | 2020-07-27 |
| 1922622380 | Ayesha Ikram | Internal Medicine | Macneal Hospital 3249 S. Oak Park Ave, Brewyn, IL 60402 | 2020-06-02 |
| 1598329146 | Eleanor Teoh | Student in an Organized Health Care Education/Training Program | Family Medicine, Macneal Family Medicine Center, 3231 Eucild Ave, 5th Floor, Berwyn, IL 60402 | 2019-04-30 |
| 1376013920 | Virginia Mireles | Behavior Technician | 2317 S. Home, Berwyn, IL 60402 | 2018-11-27 |
| 1245709047 | Saraswati Koirala | Dentist | 1227 S Harlem Ave Apt414, Berwyn, IL 60402 | 2018-11-21 |
| 1295204220 | Dental Town Ltd | Dentist | 7106 W Cermak Rd, Berwyn, IL 60402 | 2018-11-20 |
| 1396231684 | Toya M Gildart | Counselor | Pillars, 6415 Stanley Avenue, Berwyn, IL 60402 | 2018-07-10 |
| 1437655685 | Ana Luisa Desantiago | Social Worker | 3245 Grove Ave Ste 201, Berwyn, IL 60402 | 2018-04-04 |
| 1821520198 | Chetan Velagapudi | Student in an Organized Health Care Education/Training Program | 3231 S Euclid Avenue, Suite 203, Berwyn, IL 60402 | 2017-03-28 |
| 1174976567 | Sydney Talavera | Counselor | 6415 Stanley Ave., Berwyn, IL 60402 | 2016-07-20 |
| Find all providers in zip 60402 | ||||
| Taxonomy Code | 207WX0107X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| Specialization | Retina Specialist |
| An ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. |
| Notes: Source: American Society of Retina Specialists, www.asrs.org [1/1/2017: new] - Additional Resources: American Academy of Ophthalmology, www.aao.org. Macula Society, www.maculasociety.org. Retina Society, www.retinasociety.org. Association of University Professors of Ophthalmology, www.aupo.org. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275739518 | Retina Macula Specialists, P.C. | Ophthalmology | 550 E. Boughton Road Suite 120, Bilingbrook, IL 60440 | 2007-06-25 |
| 1447243407 | Irma Ahmed | Ophthalmology | 550 E. Boughton Rd, Suite 120, Bolingbrook, IL 60440 | 2005-08-25 |
| 1689666885 | Michael A Grassi | Ophthalmology | 1012 95th St Ste 9, Naperville, IL 60564-5040 | 2005-08-16 |
| 1376022426 | Marion Eye Centers Ltd. | Ophthalmology | 621 S 2nd St, Greenville, IL 62246-1744 | 2018-08-09 |
| 1790211381 | Reitna Institute of Illinois | Ophthalmology | 8780 W Golf Rd, Ste 304, Niles, IL 60714-5602 | 2017-05-03 |
| 1023472560 | Chirag Shah | Ophthalmology | 71 W 156th St Ste 400, Harvey, IL 60426-4265 | 2016-04-11 |
| 1598121113 | Grassi Retina Md Sc | Ophthalmology | 1012 95th St, Suite 9, Naperville, IL 60564-5041 | 2016-01-12 |
| 1366820441 | Omar Hassan | Ophthalmology | 1740 W Taylor St, Chicago, IL 60612-7232 | 2015-05-11 |
| 1235572173 | Ria Dirghayu Desai | Ophthalmology | 259 E Erie St Ste 1520, Chicago, IL 60611-3111 | 2013-04-10 |
| 1679836647 | Andrew W Francis | Ophthalmology | 303 W Lake St, Ste 303, Addison, IL 60101-2586 | 2012-06-24 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.