NPI | 1669687984 |
---|---|
Entity Type | Organization |
Authorized Contact | FRANCIS C LEE Physician 217-877-7171 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology (Licence: IL 036042486) |
Additional Taxonomies | 207ND0900X Dermatology, Dermatopathology (Licence: IL 036042486) |
207NI0002X Dermatology, Clinical & Laboratory Dermatological Immunology (Licence: IL 036042486) | |
207NS0135X Dermatology, Procedural Dermatology (Licence: IL 036042486) | |
Enumeration Date | 2007-05-11 |
Last Update Date | 2014-09-10 |