Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Center for Cosmetic Medicine, Ltd

Organization Specialist · NPI 1104033794

Center for Cosmetic Medicine, Ltd provides Specialist services 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 Not confirmed with CMS for 12 years — call before visiting
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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