Organization
FACIAL COSMETIC & RECONSTRUCTIVE SURGERY, SC
Active
Organization
FACIAL COSMETIC & RECONSTRUCTIVE SURGERY, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WENDY CHRISTINE MORRISON (OFFICE MANAGER)
(309) 243-8980
Entity
Organization
Contact information
Practice address
11825 N KNOXVILLE AVE, DUNLAP, IL 61525-8842
(309) 243-8980
(309) 243-8983
Mailing address
11825 N KNOXVILLE AVE, DUNLAP, IL 61525-8842
(309) 243-8980
(309) 243-8983
Taxonomy
Speciality
Code
Description
License number
State
261QS0112X
Oral and Maxillofacial Surgery Clinic/Center
Primary
019025195
IL
Other
Enumeration date
05/05/2008
Last updated
05/05/2008
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