NPI 1053994004

Forefront Dermatology, S.C.

Organisation Dermatology Physician Park Ridge, IL

Practice location

Address: 2604 Dempster St STE 101, Park Ridge, IL 60068-8425
Phone: (847) 843-3376
Fax: (847) 998-8631
Mailing address: 801 York St, Manitowoc, WI 54220-4630

Authorised official

Name: Denise L Anger
Title: Sr. Director, Provider Enrollment
Phone: (920) 663-9022

Registered specialties (3)

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X

Other Dermatology providers in Illinois →

Procedural Dermatology Physician

Allopathic & Osteopathic Physicians Taxonomy 207NS0135X

Diagnostic Radiology Physician

Allopathic & Osteopathic Physicians Taxonomy 2085R0202X

Other Radiology providers in Illinois →

Registry record

NPI: 1053994004
Entity type: Organization
NPI issued: 28 Apr 2021
Record last updated: 28 Apr 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.