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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 Specialty Code Provider Type

Plastic and Reconstructive Surgery

2086S0122X 02 Physician/General Surgery
 

Surgery

208600000X 02 Physician/General Surgery
 

Surgery of the Hand

2086S0105X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for MIDWEST PLASTIC& RECONSTRUCTIVE SURGERY

NPI Number 1316110737
LBN Legal business name MIDWEST PLASTIC& RECONSTRUCTIVE SURGERY
Authorized official SRDJAN OSTRIC - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 04/07/2008
Last updated 07/21/2008 - About 18 years ago
Identifiers
IL License # 036107060
IL Medicaid 036-107060
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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