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Organization
NORTH SHORE CENTER FOR FACIAL PLASTIC AND COSMETIC SURGERY
Active
Organization
NORTH SHORE CENTER FOR FACIAL PLASTIC AND COSMETIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY J GEROULIS M.D. (MEDICAL DIRECTOR PRESIDENT)
(847) 441-4441
Entity
Organization
Contact information
Practice address
330 W FRONTAGE RD, NORTHFIELD, IL 60093-3467
(847) 441-4441
(847) 784-9744
Mailing address
330 W FRONTAGE RD, NORTHFIELD, IL 60093-3467
(847) 441-4441
(847) 784-9744
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
036050050
IL
Other
Enumeration date
03/02/2011
Last updated
11/24/2015
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