Provider Demographics
NPI:1265074934
Name:TORIUMI FACIAL PLASTICS PLLC
Entity type:Organization
Organization Name:TORIUMI FACIAL PLASTICS PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:A
Authorized Official - Last Name:TORIUMI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-741-3202
Mailing Address - Street 1:60 E DELAWARE PL STE 1425
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-1998
Mailing Address - Country:US
Mailing Address - Phone:312-741-3202
Mailing Address - Fax:312-741-3123
Practice Address - Street 1:60 E DELAWARE PL STE 1425
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-1998
Practice Address - Country:US
Practice Address - Phone:312-741-3202
Practice Address - Fax:312-741-3123
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-14
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1124121132OtherNPI