Healthcare Provider Details

I. General information

NPI: 1851413348
Provider Name (Legal Business Name): HAND AND PLASTIC SURGERY ASSOC.,LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2007
Last Update Date: 09/28/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S YORK RD STE 3200
ELMHURST IL
60126-5626
US

IV. Provider business mailing address

1200 S YORK RD STE 3200
ELMHURST IL
60126-5626
US

V. Phone/Fax

Practice location:
  • Phone: 630-758-8777
  • Fax: 630-758-8778
Mailing address:
  • Phone: 630-758-8777
  • Fax: 630-758-8778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: SUSAN WALLENBERG
Title or Position: FINANCIAL COORDINATOR
Credential:
Phone: 630-758-8777