| NPI | 1639511249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANETTE LIEGEOIS Owner 630-928-1682 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology |
| Additional Taxonomies | 207ND0101X Dermatology, MOHS-Micrographic Surgery |
| Enumeration Date | 2013-07-24 |
| Last Update Date | 2013-07-24 |