Calisoma Cosmetic Surgery Institute LTD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

036129138 Issued in IL

Legal business name

CALISOMA COSMETIC SURGERY INSTITUTE LTD

Practice address

1460 Market St
Des Plaines, IL 60016-4643

Phone

(312) 659-8005

NPI assigned

Jul 29, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Angie Rosanne Taras, MD

Title

President

Phone

(312) 659-8005

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1406592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437350400000",
    "number": "1588072037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2760 WYNFIELD LN",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "530453352",
            "telephone_number": "312-659-8005",
            "fax_number": "815-462-4955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1460 MARKET ST",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600164643",
            "telephone_number": "312-659-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALISOMA COSMETIC SURGERY INSTITUTE LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-29",
        "last_updated": "2015-07-20",
        "status": "A",
        "authorized_official_last_name": "TARAS",
        "authorized_official_first_name": "ANGIE",
        "authorized_official_middle_name": "ROSANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "312-659-8005",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "IL",
            "license": "036129138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201083390A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Des Plaines, IL
• Providers in Des Plaines, IL by specialty
• Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2015; 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.