Center For Cosmetic And Laser Surgery, Llc

LBN: Center For Cosmetic And Laser Surgery, Llc
Center For Cosmetic And Laser Surgery, Llc is an health care organization with primary practice located at 1505 Eastland Dr Ste 350, Bloomington IL 61701-3534. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as the primary health care specialty. Center For Cosmetic And Laser Surgery, Llc can be contacted via phone (309) 663-1222, or through Poulter, Jeffrey S via phone (309) 663-1222.

Contact Information

Primary practice address
1505 Eastland Dr Ste 350 Bloomington IL 61701-3534
Phone: (309) 663-1222
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Poulter, Jeffrey S Doctor of Medicine (MD)
Phone: (309) 663-1222

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X 036084126 Illinois

Profile Details

NPI number 1215276530
LBN Legal business name Center For Cosmetic And Laser Surgery, Llc
DBA Doing business as
Authorized official Poulter, Jeffrey S Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 6th, 2013
Last updated Feb 6th, 2013 - about 11 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215276530 NPPES
Illinois MEDICAID 036084126

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