| NPI | 1396484119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAIGE LEPP President 847-208-1016 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2022-08-17 |