Organization
ADVANCED AESTHETICS SURGERY & LASER CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES M KURLEY M.D. (PRESIDENT/MEDICAL DIRECTOR)
(217) 356-3850
Entity
Organization
Contact information
Practice address
2111 WEST PARK CT., CHAMPAIGN, IL 61821
(217) 356-3850
(217) 356-3876
Mailing address
1702 MULLIKIN DR, CHAMPAIGN, IL 61822-8305
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
060.007842
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
060.007842
STATE OF ILLINOIS
IL
Enumeration date
02/05/2008
Last updated
01/08/2018
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