| NPI | 1225236086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAJENDRA R. SHAH Sole Owner 708-424-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208200000X Plastic Surgery (Licence: IL 036-054307) |
| Enumeration Date | 2007-07-03 |
| Last Update Date | 2020-08-22 |