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Physicians Plastic Surgery

Provider NPI: 1366403156

Provider Information:
Gender: M
Sole Proprietor

Practice Location:
Tel: 312-266-6240  Fax: 312-266-1411

Business Mailing Address:
Tel: 312-266-6240  Fax: 312-266-1411

NPI Information:
NPI: 1366403156
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Plastic Surgery

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 208200000X





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