Park Ridge Center For Plastic Surgery INC
Clinic/Center in Park Ridge, IL. Organization (NPI-2).
NPI number1043427826
StatusActive
Last updated in NPPESApr 7, 2011
Details
- NPI
- 1043427826
- Entity type
- Organization (NPI-2)
- Legal business name
- Park Ridge Center For Plastic Surgery INC
- Organization subpart
- No
- Enumeration date
- May 17, 2007
- Last updated
- Apr 7, 2011
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | 036093576 | IL | Yes |
Practice location
444 N. Northwest HwyPark Ridge, IL 60068
Phone 847-696-9900 · Fax 847-696-9913
Mailing address
444 N. Northwest HwyPark Ridge, IL 60068
Phone 847-696-9900 · Fax 847-696-9913
Authorized official
Sam Speron
Doctor
8476969900
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