ACADEMIC DERMATOLOGY & SKIN CANCER INSTITUTE, SC
Osteopathic Medicine at Washington St, Chicago, IL

License number
Illinois 042618008
Category
Osteopathic Medicine
Type
MOHS-Micrographic Surgery
Owner
Name: ANA BALICH
Title: OFFICE MANAGER
Phone: (312) 230-0180
Address
Address
50 E Washington St STE 200, Chicago, IL 60602
National Provider ID: 1902933146
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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ACADEMIC DERMATOLOGY & SKIN CANCER INSTITUTE, S.C

Chicago, IL 60602

Registration:
Dec 19, 2001
State ID:
61942394
Business type:
Domestic Bca
Expiration:
Perpetual
Agent:
David J Hochman,7250 N Cicero Ave STE 200, Lincolnwood, IL 60712 (Physical)

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