| NPI | 1306992128 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HANK NICHAMIN Medical Director 847-843-0200 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 036078464) |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty (Licence: IL 036078464) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2015-12-08 |