Organization · Type 2 NPI
Center of Excellence In Plastic, Aesthetic, and Reconstructive Surgery, Inc.
Plastic and Reconstructive Surgery Physician · Peoria Heights, IL
NPI number
1356293906
Active
Practice location
1310 E Samuel Ave Apt 3D
Peoria Heights, IL 61616-6497
Fax (312) 284-1030
Mailing address
152 W Huron St Unit 500
Chicago, IL 60654-7384
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Plastic and Reconstructive Surgery Physician Primary | 2086S0122X | None listed |
Plastic and Reconstructive Surgery Physician: A surgeon who specializes in plastic and reconstructive surgery.
About NPI 1356293906
Center of Excellence In Plastic, Aesthetic, and Reconstructive Surgery, Inc.'s National Provider Identifier is 1356293906, issued on Feb 13, 2026. The primary taxonomy on file is Plastic and Reconstructive Surgery Physician (2086S0122X), and the practice location is in Peoria Heights, IL. The record was last updated on Feb 13, 2026.