Organization
NORTHWESTERN ASSOC IN AESTHETIC PLASTIC & CRANIOFACIAL SURGERY SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR LAMAR LEWIS JR. (PRESIDENT)
(312) 335-9155
Entity
Organization
Contact information
Practice address
150 E HURON ST, SUITE 825, CHICAGO, IL 60611-2999
(312) 335-9155
Mailing address
150 E HURON ST, SUITE 825, CHICAGO, IL 60611-2999
(312) 335-9155
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
042004549
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036042900
—
IL
Enumeration date
05/14/2007
Last updated
06/16/2009
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