Northern Illinois Plastic Surgery

LBN: Northern Illinois Plastic Surgery
Northern Illinois Plastic Surgery is an health care organization with primary practice located at 5714 S Il Route 31 Suite A, Crystal Lake IL 60014-4520. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as the primary health care specialty. Northern Illinois Plastic Surgery can be contacted via phone (815) 356-7000, or through Roberg, Bradford C. via phone (847) 967-1149.

Contact Information

Primary practice address
5714 S Il Route 31 Suite A Crystal Lake IL 60014-4520
Fax: (815) 356-7513
Website:
Authorized official contact:
Name: Roberg, Bradford C. Doctor of Medicine (MD)

Health care specialties

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

Profile Details

NPI number 1831137520
LBN Legal business name Northern Illinois Plastic Surgery
DBA Doing business as
Authorized official Roberg, Bradford C. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Jun 3rd, 2006
Last updated Aug 22nd, 2020 - about 4 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 1831137520 NPPES
Illinois Other 00732007 BLUE SHIELD OF ILLINOIS

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