NPI | 1730188061 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY S. BAKAL President 847-882-9300 |
Organization Subpart ? | No |
Primary Taxonomy | 207N00000X Dermatology |
Additional Taxonomies | 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology |
363A00000X Physician Assistant | |
363AM0700X Physician Assistant, Medical | |
363AS0400X Physician Assistant, Surgical | |
207ND0900X Dermatology, Dermatopathology | |
207NP0225X Dermatology, Pediatric Dermatology | |
207NS0135X Dermatology, Procedural Dermatology | |
Enumeration Date | 2005-07-19 |
Last Update Date | 2020-01-29 |