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General NPI Number Information
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NPI Number | 1356293906
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Entity Type | Organization
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Legal Business Name | CENTER OF EXCELLENCE IN PLASTIC, AESTHETIC, AND RECONSTRUCTIVE SURGERY, INC.
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Dates
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Enumeration Date | 02/13/2026
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Last Update Date | 02/13/2026
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Provider Practice Location Address
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Address Line | 1310 E SAMUEL AVE APT 3D
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City | PEORIA HEIGHTS
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State | IL
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Zip | 61616-6497
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Country | US
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Telephone | 312-371-4248
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Fax | 312-284-1030
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Provider Business Mailing Address
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Address Line | 152 W HURON ST UNIT 500
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City | CHICAGO
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State | IL
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Zip | 60654-7384
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Country | US
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Telephone | 312-371-4248
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Fax | 312-284-1030
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Authorized Official
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Title or Position | PRESIDENT
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Name | AMIR H DORAFSHAR
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Credential | MD
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Telephone | 312-371-4248
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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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