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General NPI Number Information
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NPI Number | 1548783137
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Entity Type | Organization
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Legal Business Name | THE ART & SCIENCE OF COSMETIC SURGERY
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Dates
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Enumeration Date | 07/25/2017
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Last Update Date | 07/25/2017
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Provider Practice Location Address
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Address Line | 3660 N LAKE SHORE DR STE 210
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City | CHICAGO
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State | IL
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Zip | 60613-5302
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Country | US
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Telephone | 312-772-1133
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Fax |
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Provider Business Mailing Address
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Address Line | 3660 N LAKE SHORE DR APT 4101
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City | CHICAGO
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State | IL
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Zip | 60613-5317
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Country | US
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Telephone | 267-879-4268
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CYNTHIA BUONO
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Credential | DO
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Telephone | 312-722-1133
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 036133475
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License Number State | IL
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