| NPI | 1225081763 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH B BIELINSKI Physician Officer 708-636-3767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 042-007550) |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2020-08-22 |