Organization
ST CHARLES PLASTIC SURGERY, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BAHRAM GHADERI MD, FACS (PRESIDENT)
(630) 762-9697
Entity
Organization
Contact information
Practice address
2900 FOXFIELD RD, SUITE 201, SAINT CHARLES, IL 60174-5799
(630) 762-9697
Mailing address
2900 FOXFIELD RD, SUITE 201, SAINT CHARLES, IL 60174-5799
(630) 762-9697
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
036096824
IL
Other
Enumeration date
09/19/2007
Last updated
05/29/2013
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