| Organization Name: | RITACCA LASER CENTER, LTD |
| NPI Number: | 1184935405 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DAWN DAVIDSON (OFFICE MANAGER) |
| Mailing Address: | 230 Center Dr Vernon Hills |
| State: | IL US |
| Postal Code: | 600611584 |
| Phone Number: | 8473678815 |
| Fax Number: | 8663678319 |
| NPI Enumeration Date: | 07/01/2010 |
| NPI Last Update Date: | 07/01/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QA1903X |
| License Number: | 7003144 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Ambulatory Surgical |
| Taxonomy Definition: | |