| NPI | 1487846580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRIPTI BURT Owner 815-318-5010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: IL 036111195) |
| Enumeration Date | 2007-08-13 |
| Last Update Date | 2026-04-29 |