National Provider Identifier Database

MIDWEST PLASTIC RECONSTRUCTIVE SURGERY
Plastic and Reconstructive Surgery


Contact Information

MIDWEST PLASTIC& RECONSTRUCTIVE SURGERY
5645 W ADDISON ST
CHICAGO, IL60634-4403
Phone: 847-729-4879
Fax: 773-527-5070
Website:
Specialty Taxonomy Code
* Plastic and Reconstructive Surgery 2086S0122X
Surgery 208600000X
Surgery of the Hand 2086S0105X

* Indicates primary specialty

NPI Profile & details for MIDWEST PLASTIC& RECONSTRUCTIVE SURGERY

NPI Number 1316110737
Legal business name
LBN
MIDWEST PLASTIC& RECONSTRUCTIVE SURGERY
Authorized official SRDJAN OSTRIC - (PRESIDENT)
Entity Organization
Organization subpart No
Enumeration date 04/07/2008
Last updated 07/21/2008 - About 18 years ago
Sole proprietor1 Not specified
Identifiers
  • IL License #: 036107060
  • IL Medicaid: 036-107060

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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