| NPI | 1366749616 |
|---|---|
| Doing Business As | ADVANCED DERMATOLOGY |
| Entity Type | Organization |
| Authorized Contact | ISRAEL V. FERNANDO Owner/Physician 309-797-2713 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 036-101791) |
| Enumeration Date | 2011-02-23 |
| Last Update Date | 2011-02-23 |