Organization
NORTH SHORE CENTER FOR FACIAL PLASTIC AND COSMETIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY J GEROULIS M.D. (MEDICAL DIRECTOR PRESIDENT)
(847) 441-4441
Entity
Organization
Contact information
Practice address
330 W FRONTAGE RD, NORTHFIELD, IL 60093-3467
(847) 441-4441
(847) 784-9744
Mailing address
330 W FRONTAGE RD, NORTHFIELD, IL 60093-3467
(847) 441-4441
(847) 784-9744
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
036050050
IL
Other
Enumeration date
03/02/2011
Last updated
11/24/2015
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