MIDWEST PLASTIC& RECONSTRUCTIVE SURGERY (NPI# 1316110737) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316110737 |
| Entity Type | Organization |
| Organization Name | MIDWEST PLASTIC& RECONSTRUCTIVE SURGERY |
| Practice Address |
5645 W Addison St Chicago IL 60634-4403 |
| Mailing Address |
801 Windsor Rd Glenview IL 60025-3128 |
| Practice Telephone | 8477294879 |
| Practice Fax Number | 7735275070 |
| Mailing Telephone | 7735275071 |
| Mailing Fax Number | 7735275070 |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2008-07-21 |
| Authorized Official Name | SRDJAN OSTRIC (PRESIDENT) |
| Authorized Official Telephone | 3123752076 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208600000X | Surgery | 036107060 | IL | Allopathic & Osteopathic Physicians |
| N | 2086S0105X |
Surgery Specialization: Surgery of the Hand |
036107060 | IL | Allopathic & Osteopathic Physicians |
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
036107060 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036-107060 | 05 |
| Street Address |
5645 W ADDISON ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60634-4403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306845763 | Our Lady of The Resurrection Medical Center | Emergency Medicine | 5645 W Addison St, Chicago, IL 60634-4403 | 2005-07-19 |
| 1740809797 | Nicholas Donald Charmelo | Registered Nurse | 5645 W Addison St, Chicago, IL 60634-2881 | 2020-04-09 |
| 1528695814 | Ana Bulaja | Physician Assistant | 5645 W Addison St, Chicago, IL 60634-2881 | 2020-03-25 |
| 1669008702 | Jeremy Blauser | Physician Assistant | 5645 W Addison St, Chicago, IL 60634-4403 | 2020-03-20 |
| 1598306870 | Sss Pathology Services Pllc | Pathology | 5645 W Addison St, Chicago, IL 60634-4403 | 2019-10-08 |
| 1639737851 | Akhter U Patel | Nurse Practitioner | 5645 W Addison St, Chicago, IL 60634-4403 | 2019-06-03 |
| 1457916124 | Jaclyn Novak | Physician Assistant | 5645 W Addison St, Chicago, IL 60634-4403 | 2019-05-07 |
| 1962977421 | Ashley Fisher | Dietitian, Registered | 5645 W Addison St, Chicago, IL 60634-4403 | 2018-10-10 |
| 1093211153 | Brandee Joy Grenda | Dietitian, Registered | 5645 W Addison St, Chicago, IL 60634-4403 | 2018-04-05 |
| 1639687825 | Amy M Boettcher | Nurse Anesthetist, Certified Registered | 5645 W Addison St, Chicago, IL 60634-4403 | 2018-01-22 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356987333 | Alejandra Carrera | Student in an Organized Health Care Education/Training Program | 6417 W Irving Park Rd., Chicago, IL 60634 | 2019-11-25 |
| 1861977456 | Virtue Counseling Center | Counselor | 2904 N Parkside, Chicago, IL 60634 | 2018-09-28 |
| 1770931255 | Dynamic Transport Solutions LLC | Non-emergency Medical Transport (VAN) | 6109 W. Barry, Chicago, IL 60634 | 2016-05-25 |
| 1104284710 | Ez Dental | Dental Laboratory | 5621 W.montrose Avenue, Chicago, IL 60634 | 2016-02-10 |
| 1285075432 | Chicago Medical Transportation | Non-emergency Medical Transport (VAN) | 3033 N. Nordica Ave., Chicago, IL 60634 | 2013-07-16 |
| 1083985725 | Maria C. Rodriguez | Lactation Consultant, Non-RN | 6216 W. School St., Chicago, IL 60634 | 2012-01-25 |
| 1295066827 | Angie Harris | Occupational Therapist | 3339 N. Octavia, Chicago, IL 60634 | 2010-01-21 |
| 1205169802 | Belmont Dental P.C. | Dentist | 5611 W. Belmont Ave., Chicago, IL 60634 | 2009-09-14 |
| 1568605178 | Henry Biskup | Radiologic Technologist | 3105 N. Austin Ave., Chicago, IL 60634 | 2009-04-13 |
| 1306086624 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 3615 N. Central Ave, Chicago, IL 60634 | 2009-02-26 |
| Find all providers in zip 60634 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467074617 | Dewolfe Aesthetic Services Sc | Surgery | 3357 N. Southport Aveune, Chicago, IL 60657 | 2020-05-11 |
| 1780198796 | Lin Plastic and Reconstructive Surgery Inc | Surgery | 730 W Couch Pl Unit 1409, Chicago, IL 60661-1383 | 2017-11-29 |
| 1952692717 | Georgios Kokosis | Surgery | 1725 W Harrison St Ste 425, Chicago, IL 60612-3893 | 2011-04-28 |
| 1427229129 | David Teplica | Surgery | 803 W Hutchinson St, Chicago, IL 60613-1616 | 2008-03-20 |
| 1629133459 | Mckay Mckinnon | Surgery | 680 N Lake Shore Dr Ste 1208, Chicago, IL 60611 | 2006-12-22 |
| 1629029426 | Arun Gosain | Surgery | 225 E Chicago Ave # 63, Chicago, IL 60611-2991 | 2006-05-15 |
| 1992790828 | Julia Corcoran | Surgery | 1801 W Taylor St, 3f Occ Mc 741, Chicago, IL 60612-4795 | 2005-09-16 |
| 1306447586 | Aesthetics Unlimited, Pllc | Surgery | 100 E Walton St Ste 400, Chicago, IL 60611-1448 | 2020-11-04 |
| 1558913921 | Byungjoon Jeon | Surgery | 5841 S Maryland Ave, Chicago, IL 60637-1443 | 2019-07-15 |
| 1821563545 | Pipeline - Weiss Medical Specialists, LLC | Surgery | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2018-10-09 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.