Plastic and Reconstructive Surgery Center SC

Primary specialty

Surgery of the Hand (Plastic Surgery) PhysicianTaxonomy code 2082S0105X

License

036087458 Issued in IL

Legal business name

PLASTIC AND RECONSTRUCTIVE SURGERY CENTER SC

Practice address

3443 N Kennicott Ave
Arlington HTS, IL 60004-1431

Phone

(847) 577-6400

Fax

(847) 577-3194

NPI assigned

Oct 30, 2010

Organization subpart

No

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

Authorized official

Name

Dr. John A. Kotis, D.O.NPI 1649359498

Title

Ceo

Phone

(847) 577-6400

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John A Kotis, DO

  • Plastic Surgery Physician
  • Arlington Heights, IL
  • NPI 1649359498
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1288396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1288396800000",
    "number": "1528368016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3443 N KENNICOTT AVE",
            "city": "ARLINGTON HTS",
            "state": "IL",
            "postal_code": "600041431",
            "telephone_number": "847-577-6400",
            "fax_number": "847-577-3194"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3443 N KENNICOTT AVE",
            "city": "ARLINGTON HTS",
            "state": "IL",
            "postal_code": "600041431",
            "telephone_number": "847-577-6400",
            "fax_number": "847-577-3194"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC AND RECONSTRUCTIVE SURGERY CENTER SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-30",
        "last_updated": "2010-10-30",
        "status": "A",
        "authorized_official_last_name": "KOTIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-577-6400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2082S0105X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery, Surgery of the Hand",
            "state": "IL",
            "license": "036087458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036087458",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Pawelski, LCSW, MSW, MPA
• Patrice Peery
• Nancy Ann Pepe, PT
• Cecile M Petermann, LPC
• Gail Petro
• Aneta Platek, RN
• Paulina Polek, M.A.,CCC-SLP
• Kathleen A Rich, CRNA
• Eric Rittner
• Lauren Alley Rodolfo, O.D.

• Surgery of the Hand (Plastic Surgery) Physician in Arlington HTS, IL
• Providers in Arlington HTS, IL by specialty
• Surgery of the Hand (Plastic Surgery) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.