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PARK RIDGE CENTER FOR PLASTIC SURGERY INC NPI 1043427826


NPI Information

NPI: 1043427826
Provider Name: PARK RIDGE CENTER FOR PLASTIC SURGERY INC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 14D2064591

Address:
444 N. NORTHWEST HWY
PARK RIDGE, IL
ZIP 60068
Phone: (847) 696-9900
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PARK RIDGE CENTER FOR PLASTIC SURGERY INC is a clinic center in Park Ridge, IL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). PARK RIDGE CENTER FOR PLASTIC SURGERY INC NPI is 1043427826. The provider is registered as an organization entity type.

The provider's business location address is:

444 N. NORTHWEST HWY
PARK RIDGE, IL
ZIP 60068
Phone: (847) 696-9900
Fax: (847) 696-9913

The provider's authorized official is Sam Speron .
The authorized official title is Doctor and has the following contact phone number (847) 696-9900.

The CLIA number assigned to this NPI record is 14D2064591 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 5/17/2007 and was last updated on 4/7/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261Q00000XClinic/Center036093576ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1580350MEDICARE ID-TYPE UNSPECIFIEDILLINOIS
2H14201MEDICARE UPINILLINOIS
3036093576MEDICAIDILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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