Illinois Dermatology Institute, Llc

LBN: Illinois Dermatology Institute, Llc
Illinois Dermatology Institute, Llc is an health care organization with primary practice located at 1550 N Northwest Hwy Suite 300, Park Ridge IL 60068-1411. The organization recently has only one registered license in Ambulatory Health Care Facilities / Medical Specialty, which is considered as the primary health care specialty. Illinois Dermatology Institute, Llc can be contacted via phone (847) 298-1831, or through Mandrea, Steven via phone (847) 298-1831.

Contact Information

Primary practice address
1550 N Northwest Hwy Suite 300 Park Ridge IL 60068-1411
Phone: (847) 298-1831
Fax: (847) 298-1832
Website:
Map and Directions
Authorized official contact:
Name: Mandrea, Steven Doctor of Medicine (MD)
Phone: (847) 298-1831

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X 036111710 Illinois

Profile Details

NPI number 1447613989
LBN Legal business name Illinois Dermatology Institute, Llc
DBA Doing business as
Authorized official Mandrea, Steven Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Apr 1st, 2016
Last updated Apr 1st, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447613989 NPPES
Illinois MEDICAID 036111710
Illinois Other 1386663631

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