METROPOLITAN MD SC NPI 1134252273

NPI Information

METROPOLITAN MD, SC is a plastic and reconstructive surgery surgery in Glenview, IL. The provider is a surgeon who specializes in plastic and reconstructive surgery. METROPOLITAN MD, SC NPI is 1134252273. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Edward B. Lack, Mdsc.

The provider's business location address is:

2350 RAVINE WAY
SUITE 400
GLENVIEW, IL
ZIP 60025-621
Phone: (847) 832-6700
Fax: (847) 832-9430

The provider's authorized official is John D. Rachel .
The authorized official title is President and has the following contact phone number (847) 832-6700.

The CLIA number assigned to this NPI record is 14D1070468 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/14/2007 and was last updated on 1/28/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

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