Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Center for Cosmetic Medicine, Ltd

Organization Specialist · NPI 1104033794

Center for Cosmetic Medicine, Ltd is a Specialist in Decatur, Illinois. Licensed in Illinois. Registered with an NPI since 2007.

Licensed in
IL
In the registry since
2007
What do these letters mean?
Ltd — Limited
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2 Memorial Dr Ste 310
Decatur, IL 62526-3983
Phone: (217) 877-9000
Fax: (217) 877-9615
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 036060776 (IL)

Record details

NPI number1104033794
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Stuart Baker — President · (217) 877-9000
NPI enumeratedMay 16, 2007
Last updated in NPPESOctober 17, 2013
Mailing address2 Memorial Dr Ste 310, Decatur, IL 62526-3983

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