Organization
GRASSESCHI RECONSTRUCTIVE & PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITCHELL FRANK GRASSESCHI M.D. (OWNER)
(847) 328-2277
Entity
Organization
Contact information
Practice address
2500 RIDGE AVE, SUITE 208, EVANSTON, IL 60201-2455
(847) 328-2277
(847) 328-8591
Mailing address
2500 RIDGE AVE, SUITE 208, EVANSTON, IL 60201-2455
(847) 328-2277
(847) 328-8591
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360478951
—
IL
01
—
21608613
BLUE CROSS BLUE SHIELD
IL
Enumeration date
06/04/2006
Last updated
08/22/2020
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