| NPI | 1629130059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP N BUSHNICK President/Owner 847-885-1200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: IL 036060117) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2012-12-28 |