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General NPI Number Information
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NPI Number | 1023133071
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Entity Type | Organization
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Legal Business Name | PLASTIC SURGERY CONSULTANTS LTD
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Dates
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Enumeration Date | 03/20/2007
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Last Update Date | 06/14/2012
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Provider Practice Location Address
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Address Line | 199 TOWN SQ SUITE E
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City | WHEATON
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State | IL
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Zip | 60189-3878
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Country | US
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Telephone | 630-462-6858
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Fax | 630-462-1013
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Provider Business Mailing Address
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Address Line | 199 TOWN SQ SUITE E
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City | WHEATON
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State | IL
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Zip | 60189-3878
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Country | US
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Telephone | 630-462-6858
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Fax | 630-462-1013
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL A MARSCHALL
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Credential | M.D.
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Telephone | 630-462-6858
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 036071166
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 036070575
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License Number State | IL
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