Prairie Dermatology, Pllc

LBN: Prairie Dermatology, Pllc
Prairie Dermatology, Pllc is an health care organization with primary practice located at 1015 S Mercer Ave Ste Gf7 , Bloomington IL 61701-7107. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Prairie Dermatology, Pllc can be contacted via phone (309) 660-8442, or through Ginnetti, Michael Thomas via phone (309) 531-1252.

Contact Information

Primary practice address
1015 S Mercer Ave Ste Gf7 Bloomington IL 61701-7107
Phone: (309) 660-8442
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Ginnetti, Michael Thomas Doctor of Medicine (MD)
Phone: (309) 531-1252

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X

Profile Details

NPI number 1881333680
LBN Legal business name Prairie Dermatology, Pllc
DBA Doing business as
Authorized official Ginnetti, Michael Thomas Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 31st, 2022
Last updated Nov 23rd, 2022 - about 4 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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