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Organization

KAMINSKA DERMATOLOGY

Active
Other names
Kaminska Dermatology
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EDIDIONG KAMINSKA MD (PRESIDENT)
(901) 907-9820
Entity
Organization

Contact information

Practice address
3000 N HALSTED ST STE 724, CHICAGO, IL 60657-5196
(708) 628-7771
Mailing address
1776 N MILWAUKEE AVE, CHICAGO, IL 60647-5453
(312) 926-3627
(773) 862-1454

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1407083496
INDIVIDUAL NPI
Enumeration date
07/02/2019
Last updated
09/02/2019
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