| NPI | 1437678133 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIEL J. MARTINEZ-DIAZ Medical Director/Dermatologist 312-579-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 036138747) |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: IL 036138747) |
| 207NS0135X Dermatology, Procedural Dermatology (Licence: IL 036138747) | |
| Enumeration Date | 2017-09-13 |
| Last Update Date | 2022-07-21 |