| NPI | 1174984959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLARENCE WILLIAM BROWN Director 773-294-0107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IL 036096380) |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2020-12-22 |