Organization
MIDWEST CENTER FOR PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EMMANUELLA JOSEPH MD (PRESIDENT)
(217) 876-9987
Entity
Organization
Contact information
Practice address
1 MEMORIAL DR STE 216, DECATUR, IL 62526-6321
(217) 876-9987
(217) 876-1792
Mailing address
PO BOX 2077, DECATUR, IL 62524-2077
(217) 876-9987
(217) 876-1792
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
IL
Other
Enumeration date
12/10/2006
Last updated
08/22/2020
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