| NPI | 1407309560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VASSILIOS ATHANASIOS DIMITROPOULOS Physician/ Owner/ President 773-351-2862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MI 4301079801) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: MI 4301079801) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: MI 4301079801) | |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2017-01-26 |