NPI | 1093143125 |
---|---|
Doing Business As | LINCOLN PARK PLASTIC SURGERY |
Entity Type | Organization |
Authorized Contact | LAWRENCE HAL ITELD President/ Owner 312-757-4505 |
Organization Subpart ? | No |
Primary Taxonomy | 208200000X Plastic Surgery (Licence: IL 036-108014) |
Enumeration Date | 2013-10-29 |
Last Update Date | 2020-06-17 |