Provider Demographics
NPI:1043561194
Name:CHICAGO AESTHETIC SURGERY INSTITUTE, INC.
Entity Type:Organization
Organization Name:CHICAGO AESTHETIC SURGERY INSTITUTE, INC.
Other - Org Name:CASI-ND
Other - Org Type:Other Name
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:PAWLUS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:847-853-9900
Mailing Address - Street 1:10400 W HIGGINS RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROSEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60018-3705
Mailing Address - Country:US
Mailing Address - Phone:847-853-9900
Mailing Address - Fax:847-297-8208
Practice Address - Street 1:10400 W HIGGINS RD
Practice Address - Street 2:SUITE 100
Practice Address - City:ROSEMONT
Practice Address - State:IL
Practice Address - Zip Code:60018-3705
Practice Address - Country:US
Practice Address - Phone:847-853-9900
Practice Address - Fax:847-297-8208
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL336090414261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical