Active NPI
Grasseschi Reconstructive & Plastic Surgery
- Plastic Surgery Physician
- Evanston, IL
National Provider Identifier
1427097856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- Legal business name
- GRASSESCHI RECONSTRUCTIVE & PLASTIC SURGERY
- Practice address
- 2500 Ridge Ave
Suite 208
Evanston, IL 60201-2455 - Phone
- (847) 328-2277
- Fax
- (847) 328-8591
- NPI assigned
- Jun 4, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Mitchell Frank Grasseschi, M.D.
- Title
- Owner
- Phone
- (847) 328-2277
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | Primary |
Addresses
Primary practice location
2500 Ridge Ave
Suite 208
Evanston, IL 60201-2455
Mailing address
2500 Ridge Ave
Suite 208
Evanston, IL 60201-2455
Phone (847) 328-2277
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0360478951 | Medicaid | IL | |
| 21608613 | Other | IL | BLUE CROSS BLUE SHIELD |
National Provider Directory
National Provider DirectoryLocations
2500 Ridge Ave
Ste 208
Evanston, IL 60201
Phone (847) 328-2277
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Plastic Surgery Physician
- Chicago, IL
- NPI 1801863097
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149379200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1427097856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2500 RIDGE AVE",
"address_2": "SUITE 208",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602012455",
"telephone_number": "847-328-2277",
"fax_number": "847-328-8591"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2500 RIDGE AVE",
"address_2": "SUITE 208",
"city": "EVANSTON",
"state": "IL",
"postal_code": "602012455",
"telephone_number": "847-328-2277",
"fax_number": "847-328-8591"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GRASSESCHI RECONSTRUCTIVE & PLASTIC SURGERY",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-04",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "GRASSESCHI",
"authorized_official_first_name": "MITCHELL",
"authorized_official_middle_name": "FRANK",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "847-328-2277",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Plastic Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0360478951",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "21608613",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Evanston, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.