Provider Demographics
NPI:1922334226
Name:THE CHICAGO CENTER FOR PLASTIC & RECONSTRUCTIVE SURGERY, LLC
Entity Type:Organization
Organization Name:THE CHICAGO CENTER FOR PLASTIC & RECONSTRUCTIVE SURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINZWEIG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-642-0400
Mailing Address - Street 1:845 NORTH MICHIGAN AVENUE
Mailing Address - Street 2:SUITE 980W
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2218
Mailing Address - Country:US
Mailing Address - Phone:312-642-0400
Mailing Address - Fax:312-642-0500
Practice Address - Street 1:845 NORTH MICHIGAN AVENUE
Practice Address - Street 2:SUITE 980W
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2218
Practice Address - Country:US
Practice Address - Phone:312-642-0400
Practice Address - Fax:312-642-0500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-22
Last Update Date:2009-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Multi-Specialty
No2086S0105XAllopathic & Osteopathic PhysiciansSurgerySurgery of the HandGroup - Multi-Specialty
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive SurgeryGroup - Multi-Specialty