Active NPI
GT Plastic and Reconstructive Surgery, S.C.
- Plastic and Reconstructive Surgery Physician
- Elgin, IL
National Provider Identifier
1992731228
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic and Reconstructive Surgery Physician
- License
- 042-616888
- Legal business name
- GT PLASTIC AND RECONSTRUCTIVE SURGERY, S.C.
- Practice address
- 163 S Randall Rd
Elgin, IL 60123-5551 - Phone
- (847) 458-8808
- Fax
- (847) 458-8822
- NPI assigned
- Jun 26, 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
- Gunnar Thors, MD
- Title
- Owner
- Phone
- (847) 458-8808
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 and Reconstructive Surgery Physician | 2086S0122X | 042-616888 | IL | Primary |
Addresses
Primary practice location
163 S Randall Rd
Elgin, IL 60123-5551
Mailing address
PO Box 410
Barrington, IL 60011-0410
Phone (847) 458-8808
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04923242 | Other | IL | BLUECROSS/BLUESHIELD |
| 132503800 | Other | US DEPT OF LABOR-OWCP |
Other names 1
- Midwest Plastic Surgery Specialists
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
4900 S State Route 31
Crystal Lake, IL 60012
Phone (815) 455-3650
10400 Haligus Rd
Ofc
Huntley, IL 60142
Phone (224) 654-0000
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 and Reconstructive Surgery Physician
- Elgin, IL
- NPI 1508893884
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151280000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1740096000000",
"number": "1992731228",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 410",
"city": "BARRINGTON",
"state": "IL",
"postal_code": "600110410",
"telephone_number": "847-458-8808",
"fax_number": "847-458-8822"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "163 S RANDALL RD",
"city": "ELGIN",
"state": "IL",
"postal_code": "601235551",
"telephone_number": "847-458-8808",
"fax_number": "847-458-8822"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GT PLASTIC AND RECONSTRUCTIVE SURGERY, S.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-26",
"last_updated": "2025-02-21",
"certification_date": "2025-02-21",
"status": "A",
"authorized_official_last_name": "THORS",
"authorized_official_first_name": "GUNNAR",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "847-458-8808",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2086S0122X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Surgery, Plastic and Reconstructive Surgery",
"state": "IL",
"license": "042-616888",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS/BLUESHIELD",
"identifier": "04923242",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "US DEPT OF LABOR-OWCP",
"identifier": "132503800",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Midwest Plastic Surgery Specialists",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Elgin, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; 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.