Northshore Star Facial Plastic Surgery LLC

Primary specialty

Plastic Surgery Within the Head and Neck (Plastic Surgery) PhysicianTaxonomy code 2082S0099X

Legal business name

NORTHSHORE STAR FACIAL PLASTIC SURGERY LLC

Practice address

700 Osterman Ave
Deerfield, IL 60015-4375

Phone

(224) 513-6500

NPI assigned

Mar 29, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Diana Mandel-Tatch, DDSNPI 1942382494

Title

Practice Admin

Phone

(972) 898-5336

Specialties & licenses 1

Addresses

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Diana Mandel-Tatch, D.D.S.

  • General Practice Dentistry
  • Deerfield, IL
  • NPI 1942382494

  Single Specialty

  NPD Authorized official
• Walter Tatch

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Gurnee, IL
  • NPI 1285714568
  NPD

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

{
    "created_epoch": "1711670400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711670400000",
    "number": "1730930447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 OSTERMAN AVE",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154375",
            "telephone_number": "224-513-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 OSTERMAN AVE",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154375",
            "telephone_number": "224-513-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE STAR FACIAL PLASTIC SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-29",
        "last_updated": "2024-03-29",
        "certification_date": "2024-03-29",
        "status": "A",
        "authorized_official_last_name": "MANDEL-TATCH",
        "authorized_official_first_name": "DIANA",
        "authorized_official_title_or_position": "PRACTICE ADMIN",
        "authorized_official_telephone_number": "972-898-5336",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "2082S0099X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery, Plastic Surgery Within the Head and Neck",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Novak Counseling, P.C.
• Timothy John Novak, RPH
• Josh Novick
• Alex Novielli Jr., PHARMD, AAHIVP

• Plastic Surgery Physician in Deerfield, IL
• Providers in Deerfield, IL by specialty
• Plastic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2024; 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.