Advanced Dermatology

LBN: Israel V. Fernando
Advanced Dermatology is an health care organization with primary practice located at 1588 37Th Ave , Moline IL 61265-7213. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Israel V. Fernando can be contacted via phone (309) 797-2713, or through Fernando, Israel V. via phone (309) 797-2713.

Contact Information

Primary practice address
1588 37Th Ave Moline IL 61265-7213
Phone: (309) 797-2713
Fax: (309) 797-9558
Website:
Map and Directions
Authorized official contact:
Name: Fernando, Israel V. Doctor of Medicine (MD)
Phone: (309) 797-2713

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 036-101791 Illinois

Profile Details

NPI number 1366749616
LBN Legal business name Israel V. Fernando
DBA Doing business as Advanced Dermatology
Authorized official Fernando, Israel V. Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Feb 23rd, 2011
Last updated Feb 23rd, 2011 - about 15 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 1366749616 NPPES
Iowa MEDICAID 2252064

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