ASMSC-MORTON GROVE IL SC

MORTON GROVE, IL
NPI1679158174
Entity TypeOrganization
Authorized ContactCLARENCE W BROWN
Owner/CEO/President
269-985-0021
Organization Subpart ?No
Primary Taxonomy207N00000X Dermatology
Additional Taxonomies207ND0101X Dermatology, MOHS-Micrographic Surgery
207ND0900X Dermatology, Dermatopathology
207ZD0900X Pathology, Dermatopathology
Enumeration Date2021-03-16
Last Update Date2021-03-16
Business Address
ASMSC-MORTON GROVE IL SC
9300 WAUKEGAN RD
MORTON GROVE, IL 60053-1312
Phone number: 847-299-1044
Mailing Address
ASMSC-MORTON GROVE IL SC
2570 NILES RD
SAINT JOSEPH, MI 49085-3203
Phone number: 269-985-0021