| NPI | 1487751335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKIMERLY MICHELLE COATES President 815-399-6400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: IL 042617821) |
| Additional Taxonomies | 207NS0135X Dermatology, Procedural Dermatology (Licence: IL 042617821) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2018-02-19 |