Provider Demographics
NPI:1629279518
Name:MIDWEST COSMETIC INSTITUTE
Entity Type:Organization
Organization Name:MIDWEST COSMETIC INSTITUTE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MAYER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-223-9494
Mailing Address - Street 1:609 ACADEMY DR
Mailing Address - Street 2:
Mailing Address - City:NORTHBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60062-2420
Mailing Address - Country:US
Mailing Address - Phone:847-223-9494
Mailing Address - Fax:847-205-9722
Practice Address - Street 1:1215 MCHENRY RD
Practice Address - Street 2:SUITE 130A
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1370
Practice Address - Country:US
Practice Address - Phone:847-223-9494
Practice Address - Fax:847-205-9722
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MIDWEST COSMETIC INSTITUTE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-05-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL163WS0121X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WS0121XNursing Service ProvidersRegistered NursePlastic SurgeryGroup - Single Specialty