| NPI | 1386777241 |
|---|---|
| Former Legal Business Name | DERMATOLOGY AND AESTHETICS OF WICKER PARK, LLC |
| Entity Type | Organization |
| Authorized Contact | NEHA ROBINSON Owner/ Physician 773-276-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2021-01-08 |