Midwest Plastic& Reconstructive Surgery

Primary specialty

Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X

License

036107060 Issued in IL

Legal business name

MIDWEST PLASTIC& RECONSTRUCTIVE SURGERY

Practice address

5645 W Addison St
Chicago, IL 60634-4403

Phone

(847) 729-4879

Fax

(773) 527-5070

NPI assigned

Apr 7, 2008

Last updated

Jul 21, 2008By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Srdjan Ostric

Title

President

Phone

(312) 375-2076

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216598400000",
    "number": "1316110737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 WINDSOR RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600253128",
            "telephone_number": "773-527-5071",
            "fax_number": "773-527-5070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5645 W ADDISON ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606344403",
            "telephone_number": "847-729-4879",
            "fax_number": "773-527-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST PLASTIC& RECONSTRUCTIVE SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-07",
        "last_updated": "2008-07-21",
        "status": "A",
        "authorized_official_last_name": "OSTRIC",
        "authorized_official_first_name": "SRDJAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-375-2076"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "IL",
            "license": "036107060",
            "primary": false
        },
        {
            "code": "2086S0105X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgery of the Hand",
            "state": "IL",
            "license": "036107060",
            "primary": false
        },
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "IL",
            "license": "036107060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036-107060",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Midwest Physician Group LTD (MPC-Medicine & Surgery)
• Midwest Physician Group LTD (Midwest Physician Center of Beverly)
• Midwest Physician Group LTD (Midwest Physician Center of Bridgeport)
• Midwest Physician Network
• Midwest Physicians Network Inc
• Midwest Podiatric Physicians, P.C.
• Midwest Podiatry Services LTD (Weil Foot and Ankle Institute LLC)
• Midwest Post Acute Care Aco PLLC
• Midwest Post Acute Care LLC
• Midwest Post Acute Care of California Aco PC

• Plastic and Reconstructive Surgery Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Plastic and Reconstructive Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.