PLASTIC SURGERY CONSULTANTS, P.C. (NPI# 1578551065) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578551065 |
| Entity Type | Organization |
| Organization Name | PLASTIC SURGERY CONSULTANTS, P.C. |
| Other Organization Name | PLASTIC SURGERY CONSULTANTS OF ILLINOIS |
| Practice Address |
4600 Memorial Dr Medical Office Building 2 - Suite 320 Belleville IL 62226-5366 |
| Practice Telephone | 6182572100 |
| Practice Fax Number | 6182572169 |
| Mailing Telephone | 6182572100 |
| Mailing Fax Number | 6182572169 |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ROBERT C. WANLESS (PRESIDENT) |
| Authorized Official Telephone | 6182572100 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208200000X | Plastic Surgery | IL | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Plastic Surgery Consultants of Illinois | Doing Business As Name - Organization |
| Street Address |
4600 MEMORIAL DR MEDICAL OFFICE BUILDING 2 - SUITE 320 |
| City | BELLEVILLE |
| State | IL |
| Zip Code | 62226-5366 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245234988 | Ellen Middendorf | Family Medicine | 4600 Memorial Dr, Ste. 160, Belleville, IL 62226-5368 | 2005-06-10 |
| 1922594142 | Keli Nicole Keener | Specialist/Technologist | 4600 Memorial Dr, Belleville, IL 62226-5368 | 2018-07-11 |
| 1952849770 | Kendra Jane Green | Nurse Practitioner | 4600 Memorial Dr, Ste 80, Belleville, IL 62226-5359 | 2017-02-01 |
| 1427504042 | Catherine Bennett | Nurse Practitioner | 4600 Memorial Dr, Suite 200, Belleville, IL 62226-5368 | 2016-09-01 |
| 1558738237 | Christina Moore | Physician Assistant | 4600 Memorial Dr, Suite 200, Belleville, IL 62226-5368 | 2015-08-28 |
| 1588056147 | Miranda Boeckman | Physician Assistant | 4600 Memorial Dr, Belleville, IL 62226-5368 | 2015-02-19 |
| 1033510284 | Msa Alliance, LLC Dba-southern Illinois Vascular and Vein Surgery | Surgery | 4600 Memorial Dr, Suite120, Belleville, IL 62226-5368 | 2014-09-08 |
| 1548680267 | Msa Alliance, LLC | Surgery | 4600 Memorial Dr, Suite W2, Belleville, IL 62226-5368 | 2014-04-21 |
| 1770925760 | Msa Alliance, LLC | Internal Medicine | 4600 Memorial Dr, Suite 200, Belleville, IL 62226-5368 | 2013-07-19 |
| 1982045514 | Ashley A. Wittler | Nurse Practitioner | 4600 Memorial Dr, Ste. 400, Belleville, IL 62226-5368 | 2013-07-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639778160 | Roxanna Lee Gunnels | Nurse Practitioner | 1 Bronze Pointe Plaza Suite 1a, Swansea, IL 62226 | 2020-10-26 |
| 1053969790 | Consistent Medical Transportation | Driver | 2012 N 17th St, Swansea, IL 62226 | 2019-08-27 |
| 1497314371 | Medi-plex Hospice of Illinois, LLC | Registered Nurse | 8 Park Place, Suite #3, Swansea, IL 62226 | 2019-06-13 |
| 1336617364 | Nicole Renee Schmidt | Speech-Language Pathologist | 150 N 27th St., Belleville, IL 62226 | 2018-11-07 |
| 1295258903 | Catherine Espino | Pharmacist | 11 Chambers Blvd, Swansea, IL 62226 | 2017-07-25 |
| 1366806838 | Kiley Faires | Nurse Practitioner | 4600 Memorial Drive Ste 360, Belleville, IL 62226 | 2016-04-11 |
| 1760857585 | Mvp Transportation | Non-emergency Medical Transport (VAN) | 1229 N 17th Street, Number 23, Belleville, IL 62226 | 2015-12-04 |
| 1275952566 | Aisha Danyale Franklin | Internal Medicine | 4261 Woodfield Pl, Belleville, IL 62226 | 2014-04-15 |
| 1396168332 | Jayne E. Ninness | Physical Therapy Assistant | 4500 Memorial Dr., Memorial Hospital, Belleville, IL 62226 | 2014-01-28 |
| 1053758193 | Gateway Foundation, Inc. | Clinic/Center | 1 Bronze Point, Suite 1, Swansea, IL 62226 | 2013-05-30 |
| Find all providers in zip 62226 | ||||
| Taxonomy Code | 208200000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Plastic Surgery |
| A plastic surgeon deals with the repair, reconstruction or replacement of physical defects of form or function involving the skin, musculoskeletal system, craniomaxillofacial structures, hand, extremities, breast and trunk and external genitalia or cosmetic enhancement of these areas of the body. Cosmetic surgery is an essential component of plastic surgery. The plastic surgeon uses cosmetic surgical principles to both improve overall appearance and to optimize the outcome of reconstructive procedures. The surgeon uses aesthetic surgical principles not only to improve undesirable qualities of normal structures but in all reconstructive procedures as well. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Plastic Surgery, 2007. http://www.abplsurg.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Plastic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427204965 | Elizabeth Renaker-jansen | Plastic Surgery | 340 W Lincoln St, Suite 500, Belleville, IL 62220-1900 | 2008-08-15 |
| 1528214624 | Vidya Shankaran | Plastic Surgery | 340 W Lincoln St, Ste 500, Belleville, IL 62220-1900 | 2008-08-08 |
| 1558556878 | St. Elizabeth's Hospital | Plastic Surgery | 2900 Frank Scott Pkwy W, Suite 970, Belleville, IL 62223-5000 | 2007-09-10 |
| 1548258288 | Robert C. Wanless | Plastic Surgery | 4600 Memorial Dr, Suite 320, Belleville, IL 62226-5366 | 2005-10-06 |
| 1215922067 | Richard J. Hehmann | Plastic Surgery | 4600 Memorial Dr, Suite 320, Belleville, IL 62226-5366 | 2005-09-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093363236 | Stephen A Madry Md | Plastic Surgery | 27750 W Il Route 22 Ste 230, Barrington, IL 60010-1924 | 2019-08-30 |
| 1588129928 | Rosett Plastic Surgery, LLC | Plastic Surgery | 1149 Crofton Ave N, Highland Park, IL 60035-3953 | 2019-02-08 |
| 1922572411 | Plastic Surgery Services and Equipment LLC | Plastic Surgery | 3050 Finley Rd Ste 300b, Downers Grove, IL 60515-1369 | 2019-01-17 |
| 1710487095 | Bradley Ashpole Md LLC | Plastic Surgery | 501 W Golf Rd Ste A, Schaumburg, IL 60195-3502 | 2018-02-13 |
| 1821501586 | Plastic Surgery Clinic of Chicago LLC | Plastic Surgery | 850 S Wabash Ave Ste 310, Chicago, IL 60605-3642 | 2017-11-15 |
| 1720500085 | Warner Aesthetic & Reconstructive Institute | Plastic Surgery | 570 Lincoln Ave Lowr Level4, Winnetka, IL 60093-2355 | 2017-07-08 |
| 1902258874 | Rashid Plastic Surgery, LLC | Plastic Surgery | 804 W Trailcreek Drive, Peoria, IL 61614 | 2016-07-05 |
| 1073977369 | Subramaniam Arumugam | Plastic Surgery | 13020 S Winnebago Rd, Palos Heights, IL 60463-2056 | 2016-04-12 |
| 1598123424 | Craig Bradley | Plastic Surgery | 1035 W Rundell Pl, Chicago, IL 60607-2514 | 2016-02-06 |
| 1215346325 | Damian Gress | Plastic Surgery | 943 W 14th Pl, Unit 2 B, Chicago, IL 60608-2287 | 2014-08-04 |
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| City | BELLEVILLE |
| Zip Code | 62226 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.