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General NPI Number Information
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NPI Number | 1629279518
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Entity Type | Organization
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Legal Business Name | MIDWEST COSMETIC INSTITUTE
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1215 MCHENRY RD SUITE 130A
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-1370
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Country | US
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Telephone | 847-223-9494
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Fax | 847-205-9722
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Provider Business Mailing Address
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Address Line | 609 ACADEMY DR
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City | NORTHBROOK
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State | IL
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Zip | 60062-2420
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Country | US
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Telephone | 847-223-9494
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Fax | 847-205-9722
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Authorized Official
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Title or Position | PARTNER
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Name | DR. MAYER ZAYAN
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Credential | MD
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Telephone | 847-223-9494
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WS0121X
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Taxonomy Name | Plastic Surgery Registered Nurse
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License Number |
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License Number State | IL
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