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