Provider Demographics
NPI:1548599285
Name:LU PLASTIC SURGERY SC
Entity Type:Organization
Organization Name:LU PLASTIC SURGERY SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LEONARD
Authorized Official - Middle Name:
Authorized Official - Last Name:LU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-250-7887
Mailing Address - Street 1:60 INDIAN HILL RD
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-3938
Mailing Address - Country:US
Mailing Address - Phone:847-250-7887
Mailing Address - Fax:
Practice Address - Street 1:60 INDIAN HILL RD
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-3938
Practice Address - Country:US
Practice Address - Phone:847-250-7887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.109219208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty