| NPI | 1063461671 |
|---|---|
| Doing Business As | ADVANCED DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | ISRAEL V FERNANDO Owner 309-797-3713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2020-08-22 |