| NPI | 1144610080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIKRAM KHANNA President 847-528-1177 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2023-06-26 |