Organization Name:  HEAD & NECK COSMETIC SURGERY ASSOCIATES LLC


Practice Location:
8930 GROSS POINT RD STE 700  SKOKIE, IL 60077 US
Tel: 773-262-4110  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

Primary	Code	Category/Description	State	License Number
N	207K00000X	Physicians Allergy & Immunology	IL	036087798
N	207YS0012X	Physicians Otolaryngology	IL	036047479
Y	207Y00000X	Physicians Otolaryngology	IL	036047479

Other Provider Identifiers:

Issuer	Number	State	Type
RAILROAD MEDICARE	CC4902	IL	01
BLUE CROSS BLUE SHIELD	01623471	IL	01

Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin