Provider Demographics
NPI:1972658714
Name:NORTHWEST PLASTIC SURGEONS
Entity Type:Organization
Organization Name:NORTHWEST PLASTIC SURGEONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARVYDAS
Authorized Official - Middle Name:
Authorized Official - Last Name:TAURAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-398-2466
Mailing Address - Street 1:1100 W CENTRAL RD
Mailing Address - Street 2:SUITE 206
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-2402
Mailing Address - Country:US
Mailing Address - Phone:847-398-2466
Mailing Address - Fax:847-398-6027
Practice Address - Street 1:1100 W CENTRAL RD
Practice Address - Street 2:SUITE 206
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-2402
Practice Address - Country:US
Practice Address - Phone:847-398-2466
Practice Address - Fax:847-398-6027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0021607075OtherBLUE CROSS BLUE SHIELD
IL0021607075OtherBLUE CROSS BLUE SHIELD
ILC42381Medicare UPIN