OrganizationActive
Premier Medical Group, LLC
NPI 1487943593 · Plastic Surgery Physician · Bloomington, IL
Provider details
- NPI number
- 1487943593
- Entity type
- Organization
- Primary specialty
- Plastic Surgery PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- John Hesse, Executive Administrator(309) 662-6200
- License
- 36-084126 (IL)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
1505 Eastland Dr
Suite 350
Bloomington, IL 61701-3534
Phone: (309) 663-1222
Fax: (309) 663-0580
Street-level locationGet directions
Mailing address
1505 Eastland Dr
Bloomington, IL 61701-3534
Other names (DBA / former)
- Doing business as
- Center for Cosmetic and Laser Surgery, LLC
Registry dates
- Enumerated
- 2011-03-30
- Last updated
- 2011-03-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.