PLASTIC AND RECONSTRUCTIVE SURGERY CENTER SC (NPI# 1528368016) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528368016 |
| Entity Type | Organization |
| Organization Name | PLASTIC AND RECONSTRUCTIVE SURGERY CENTER SC |
| Practice Address |
3443 N Kennicott Ave Arlington Hts IL 60004-1431 |
| Practice Telephone | 8475776400 |
| Practice Fax Number | 8475773194 |
| Mailing Telephone | 8475776400 |
| Mailing Fax Number | 8475773194 |
| Enumeration Date | 2010-10-30 |
| Last Update Date | 2010-10-30 |
| Authorized Official Name | DR. JOHN A. KOTIS (CEO) |
| Authorized Official Telephone | 8475776400 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2082S0105X |
Plastic Surgery Specialization: Surgery of the Hand |
036087458 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036087458 | 05 |
| Street Address |
3443 N KENNICOTT AVE |
| City | ARLINGTON HTS |
| State | IL |
| Zip Code | 60004-1431 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023659638 | Wayne L. Tsutsumi | Technician | 1106 E. Mayfair Road, Arlington Heights, IL 60004 | 2019-10-04 |
| 1598275562 | Tyler James Kostecki | Physician Assistant | 3405 North Arlington Heights Road, Arlington Heights, IL 60004 | 2017-10-04 |
| 1104345628 | Diane Kaffka | Speech-Language Pathologist | 2330 N. Verde Ave, Arlington Heights, IL 60004 | 2017-09-15 |
| 1508302373 | Maureen O'connor I | Behavioral Analyst | 3385 N Arlighton Heights Road, Arlighton Heights, IL 60004 | 2017-01-17 |
| 1366985210 | Brian Zulawinski, Dds, LLC | Dentist | 15 N. Arlington Heights Rd, Arlington Heights, IL 60004 | 2016-11-28 |
| 1568918282 | Andrea M Doshi | Speech-Language Pathologist | 1965 N Oakwood Drive, Arlington Heights, IL 60004 | 2016-09-01 |
| 1932514437 | Prone Solutions Inc. | Durable Medical Equipment & Medical Supplies | 126 South Dwyer Avenue, Arlington Heights, IL 60004 | 2014-06-24 |
| 1255751251 | Joann F. Hamm, O.d., P.C. | Optometrist | 1504 N. Arlington Heights Rd., Arlington Heights, IL 60004 | 2014-04-17 |
| 1669891602 | N Joshi Md Sc | Psychiatry & Neurology | 1430 N. Arlington Heights Road Suite 205, Arlington Heights, IL 60004 | 2014-04-07 |
| 1891123329 | Dana Portman | Pharmacist | 325 Palatine Road, Arlington Heights, IL 60004 | 2013-10-18 |
| Find all providers in zip 60004 | ||||
| Taxonomy Code | 2082S0105X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| Specialization | Surgery of the Hand |
| A plastic surgeon with additional training in the investigation, preservation, and restoration by medical, surgical and rehabilitative means of all structures of the upper extremity directly affecting the form and function of the hand and wrist. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326305632 | Jack Michael Monasterio | Plastic Surgery | 26w295 Glen Eagles Dr, Winfield, IL 60190-2313 | 2012-04-12 |
| 1619118536 | Mac Medical Services Corp | Plastic Surgery | 2314 S Route 59, #180, Plainfield, IL 60586-7756 | 2009-03-23 |
| 1770757130 | Jacob Maxwell-phillip Bloom | Plastic Surgery | 1 E Delaware Pl Ste 501, Chicago, IL 60611 | 2008-04-16 |
| 1508034596 | Theodore D. Fifer | Plastic Surgery | 14900 N Court 9, Effingham, IL 62401-7640 | 2008-02-13 |
| 1487662557 | Vic T. Tsai, M.d., S.c. | Plastic Surgery | 823 129th Infantry Dr Ste 103, Joliet, IL 60435-8347 | 2006-08-04 |
| 1700823879 | Robert C Russell | Plastic Surgery | 320 E Carpenter St, Springfield, IL 62702-5185 | 2006-05-31 |
| 1669475794 | Raymond V Janevicius | Plastic Surgery | 360 W Butterfield Rd, Ste 230, Elmhurst, IL 60126-5000 | 2005-05-23 |
| 1831508910 | Allyne Topaz | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2014-08-04 |
| 1700140613 | Midamerica Orthopaedics, S.c. | Plastic Surgery | 19065 Hickory Creek Dr, Suite 210, Mokena, IL 60448-8507 | 2012-06-26 |
| 1881906535 | Alan Chen Surgical Associates, PC | Plastic Surgery | 823 N 129th Infantry Dr, Ste 103, Joliet, IL 60435-8346 | 2010-07-10 |
| Find all providers with the same taxonomy | ||||
| City | ARLINGTON HTS |
| Zip Code | 60004 |
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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.