Organization
COSMETIC & PLASTIC SURGERY ASSOCIATES MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP N BUSHNICK M.D. (PRESIDENT/OWNER)
(847) 885-1200
Entity
Organization
Contact information
Practice address
1786 MOON LAKE BLVD, SUITE 205, HOFFMAN ESTATES, IL 60169-1067
(847) 885-1200
(847) 885-1212
Mailing address
1786 MOON LAKE BLVD, SUITE 205, HOFFMAN ESTATES, IL 60169-1067
(847) 885-1200
(847) 885-1212
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
036060117
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036060117
—
IL
01
—
1625882
BLUE CROSS BLUE SHIELD
IL
Enumeration date
12/14/2006
Last updated
12/28/2012
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