NPI 1063978138

Dermatology Physicians Sc

Organisation Dermatology Physician Chicago, IL

Practice location

Address: 680 N Lake Shore Dr STE 1208, Chicago, IL 60611-8701
Phone: (312) 483-4397
Mailing address: 640 N Wells St APT 1003, Chicago, IL 60654-3958

Authorised official

Name: Motunrayo Adisa
Title: Owner
Phone: (773) 875-2029

Registered specialties

Dermatology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207N00000X

Other Dermatology providers in Illinois →

Registry record

NPI: 1063978138
Entity type: Organization
NPI issued: 13 Feb 2019
Record last updated: 30 Mar 2020

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.