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General NPI Number Information
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NPI Number | 1225619588
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Entity Type | Organization
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Legal Business Name | NORTH SHORE FAMILY PLASTIC SURGERY LLC
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Dates
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Enumeration Date | 04/19/2021
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 9000 WAUKEGAN RD STE 130
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City | MORTON GROVE
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State | IL
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Zip | 60053-2128
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Country | US
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Telephone | 847-820-9122
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Fax |
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Provider Business Mailing Address
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Address Line | 9000 WAUKEGAN RD STE 130
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City | MORTON GROVE
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State | IL
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Zip | 60053-2128
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Country | US
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Telephone | 847-820-9122
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SARA DICKIE
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Credential | MD
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Telephone | 847-999-7800
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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 |
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License Number State |
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