| NPI | 1861585390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS H FENDON President 847-531-6340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery (Licence: IL 036074699) |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2022-05-26 |