Individual
AMY P ORSINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1519 LEGACY CIR, NAPERVILLE, IL 60563-3161
(630) 300-0015
(630) 300-0014
Mailing address
1519 LEGACY CIR, NAPERVILLE, IL 60563-3161
(630) 300-0015
(630) 300-0014
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
036112985
IL
207N00000X
Dermatology Physician
4301104886
MI
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
4301104886
MI
207NS0135X
Procedural Dermatology Physician
4301104886
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036112985
IL STATE LIC
IL
Enumeration date
07/15/2006
Last updated
08/09/2021
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