Organization
LAKE SHORE PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ALAN HORN M.D. (PRESIDENT)
(312) 202-9000
Entity
Organization
Contact information
Practice address
60 E DELAWARE PL, 15TH FL, CHICAGO, IL 60611-1998
(312) 202-9000
(312) 202-9002
Mailing address
60 E DELAWARE PL, 15TH FL, CHICAGO, IL 60611-1998
(312) 202-9000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036092789
IL
Other
Enumeration date
02/01/2011
Last updated
02/01/2011
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