Organization
LOOP DERMATOLOGY & ACNE CARE CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHELE BURGESS MD (OWNER)
(312) 519-1465
Entity
Organization
Contact information
Practice address
111 N WABASH AVE, SUITE 2001, CHICAGO, IL 60602-1903
(312) 519-1465
Mailing address
111 N WABASH AVE, SUITE 2001, CHICAGO, IL 60602-1903
(312) 519-1465
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
03610878
IL
Other
Enumeration date
05/14/2008
Last updated
11/06/2013
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