NPI | 1649807074 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID OTHMAN President 312-600-5826 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
Additional Taxonomies | 207N00000X Dermatology |
207ND0101X Dermatology, MOHS-Micrographic Surgery | |
207ND0900X Dermatology, Dermatopathology | |
207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology | |
207NP0225X Dermatology, Pediatric Dermatology | |
207NS0135X Dermatology, Procedural Dermatology | |
261QA1903X Clinic/Center, Ambulatory Surgical | |
Enumeration Date | 2020-03-25 |
Last Update Date | 2020-07-15 |