Provider Demographics
NPI:1851413348
Name:HAND AND PLASTIC SURGERY ASSOC.,LTD.
Entity Type:Organization
Organization Name:HAND AND PLASTIC SURGERY ASSOC.,LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCIAL COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLENBERG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-758-8777
Mailing Address - Street 1:1200 S YORK RD
Mailing Address - Street 2:STE 3200
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5626
Mailing Address - Country:US
Mailing Address - Phone:630-758-8777
Mailing Address - Fax:630-758-8778
Practice Address - Street 1:1200 S YORK RD
Practice Address - Street 2:STE 3200
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5626
Practice Address - Country:US
Practice Address - Phone:630-758-8777
Practice Address - Fax:630-758-8778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-04
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCH5107OtherRAIL ROAD
ILCK3769OtherRAIL ROAD
IL591040Medicare PIN
IL202589Medicare PIN