Northside Dermatology, SC
Northside Dermatology, SC is a Medical Specialty Clinic/Center in Chicago, Illinois. Licensed in Illinois. Registered with an NPI since 2016.
- Licensed in
- IL
- In the registry since
- 2016
Practice location Address checks out
1663 W Carmen AveChicago, IL 60640-2701
Phone: (312) 420-7409
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Medical Specialty Clinic/Center (primary) | Taxonomy 261QM2500X · Licence 036.132972 (IL) |
|---|
Record details
| NPI number | 1861943888 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | James Ida — Practice Owner · (773) 293-7500 |
| NPI enumerated | October 14, 2016 |
| Last updated in NPPES | April 20, 2020 |
| Certification date | April 20, 2020 |
| Mailing address | 1663 W Carmen Ave, Chicago, IL 60640-2701 |
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