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General NPI Number Information
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NPI Number | 1124253034
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Entity Type | Organization
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Legal Business Name | FLORENCE MUSSAT MD SC
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Dates
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Enumeration Date | 05/20/2009
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Last Update Date | 08/27/2012
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Provider Practice Location Address
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Address Line | 680 N LAKE SHORE DR SUITE 1030
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City | CHICAGO
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State | IL
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Zip | 60611-4546
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Country | US
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Telephone | 312-751-9000
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Fax | 312-751-9011
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Provider Business Mailing Address
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Address Line | 680 N LAKE SHORE DR SUITE 1030
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City | CHICAGO
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State | IL
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Zip | 60611-4546
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Country | US
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Telephone | 312-751-9000
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Fax | 773-868-3700
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. FLORENCE MUSSAT
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Credential | M.D.
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Telephone | 312-751-9000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | 036085474
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License Number State | IL
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