NPI | 1588283402 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID OTHMAN President And CEO 312-600-5826 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology |
Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
Enumeration Date | 2020-04-10 |
Last Update Date | 2025-02-27 |