| Village Dermatology, Sc | |
|
401 Linden Ave Wilmette IL 60091-2844 | |
| (847) 920-9177 | |
| (847) 920-9188 |
| Full Name | Village Dermatology, Sc |
|---|---|
| Speciality | Clinic/center |
| Location | 401 Linden Ave, Wilmette, Illinois |
| Authorized Official Name and Position | Cecelia H Ricketts (OWNER) |
| Authorized Official Contact | 8479209177 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Village Dermatology, Sc 401 Linden Ave Wilmette IL 60091-2844 Ph: (847) 920-9177 | Village Dermatology, Sc 401 Linden Ave Wilmette IL 60091-2844 Ph: (847) 920-9177 |
| NPI Number | 1518210327 |
|---|---|
| Provider Enumeration Date | 10/17/2012 |
| Last Update Date | 10/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518210327 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 042619944 (Illinois) | Primary |
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