is a Mohs-micrographic Surgery in Naperville, Illinois. practices all healthcare services and medical treatments related to Mohs-micrographic Surgery. The NPI Number for is 1457518490. The last update date is .
's current location address is 1519 Legacy Cir, Naperville, Illinois. You can contact this provider via phone number 6304738901. The mailing address for is 1519 Legacy Cir, Naperville, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | |
|---|---|
| Address | 1519 Legacy Cir, Naperville, Illinois |
| Phone Number | 6304738901 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
NPI Number Detail
| NPI Number | 1457518490 |
|---|---|
| Provider Enumeration Date | |
| Last Updated Date |
Provider Mailing Address Detail
| Address | 1519 Legacy Cir |
|---|---|
| City | Naperville |
| State | Illinois (IL) |
| Post Code | 605633161 |
| Phone Number | 6304738901 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Mohs-micrographic Surgery |
|---|---|
| Taxonomy | 207Nd0101X |
| Licence No | 4301091563 |
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Definition: The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 283860904 | TX | ARC ROT MEDICAID | |
| 372614YKXV | TX | ARC TRAVIS MEDICARE | |
| 283860903 | TX | ARC TRAVIS MEDICAID | |
| 372614YKXY | TX | ARC ROT MEDICARE | |
| 4301091563 | MI | MICHIGAN LIMITED EDUCATION LIC |
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