| Park Ridge Center For Plastic Surgery Inc | |
|
444 N. Northwest Hwy Park Ridge IL 60068 | |
| (847) 696-9900 | |
| (847) 696-9913 |
| Full Name | Park Ridge Center For Plastic Surgery Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 444 N. Northwest Hwy, Park Ridge, Illinois |
| Authorized Official Name and Position | Sam Speron (DOCTOR) |
| Authorized Official Contact | 8476969900 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Ridge Center For Plastic Surgery Inc 444 N. Northwest Hwy Park Ridge IL 60068 Ph: (847) 696-9900 | Park Ridge Center For Plastic Surgery Inc 444 N. Northwest Hwy Park Ridge IL 60068 Ph: (847) 696-9900 |
| NPI Number | 1043427826 |
|---|---|
| Provider Enumeration Date | 05/17/2007 |
| Last Update Date | 04/07/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043427826 | NPI | - | NPPES |
| 036093576 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 036093576 (Illinois) | Primary |
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