# PLASTIC AND RECONSTRUCTIVE SURGERY CENTER SC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528368016
- **Authorized official:** DR. JOHN A. KOTIS D.O. (CEO)
- **Authorized official phone:** (847) 577-6400

## Contact information

- **Practice address:** 3443 N KENNICOTT AVE, ARLINGTON HTS, IL 60004-1431
- **Practice address phone:** (847) 577-6400
- **Practice address fax:** (847) 577-3194
- **Mailing address:** 3443 N KENNICOTT AVE, ARLINGTON HTS, IL 60004-1431
- **Mailing address phone:** (847) 577-6400
- **Mailing address fax:** (847) 577-3194

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2082S0105X | Surgery of the Hand (Plastic Surgery) Physician | 036087458 | IL | Yes |

## Other

- **Enumeration date:** 10/30/2010
- **Last updated:** 10/30/2010