Organization Active NPI

Plastic Surgery Specialists of Illinois SC

  • Plastic Surgery Physician
  • Frankfort, IL
National Provider Identifier
1619025350
Registry record updated Jul 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
Legal business name
PLASTIC SURGERY SPECIALISTS OF ILLINOIS SC
Practice address
20635 Abbey Woods CT N
Suite 202
Frankfort, IL 60423-3181
Phone
(815) 806-9400
Fax
(815) 806-9550
NPI assigned
Jan 8, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2008

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

Authorized official

Name
Karen Welke
Title
Office Manager
Phone
(815) 806-9400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X Primary

Addresses

Primary practice location

20635 Abbey Woods CT N
Suite 202
Frankfort, IL 60423-3181

Mailing address

20635 Abbey Woods CT N
Suite 202
Frankfort, IL 60423-3181
Phone (815) 806-9400

National Provider Directory

National Provider Directory

Locations

20635 Abbey Woods Ct N
Ste 202
Frankfort, IL 60423
Phone (815) 806-9400

NPI Registry JSON

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216339200000",
    "number": "1619025350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20635 ABBEY WOODS CT N",
            "address_2": "SUITE 202",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604233181",
            "telephone_number": "815-806-9400",
            "fax_number": "815-806-9550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20635 ABBEY WOODS CT N",
            "address_2": "SUITE 202",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604233181",
            "telephone_number": "815-806-9400",
            "fax_number": "815-806-9550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY SPECIALISTS OF ILLINOIS SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2008-07-18",
        "status": "A",
        "authorized_official_last_name": "WELKE",
        "authorized_official_first_name": "KAREN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "815-806-9400"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.