Organization
MIDWEST DERMATOLOGY INSTITUTE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN GOULDER MD (OWNER/MEDICAL DIRECTOR)
(312) 498-4409
Entity
Organization
Contact information
Practice address
500 E OGDEN AVE STE 200, HINSDALE, IL 60521-2480
(312) 498-4409
Mailing address
500 E OGDEN AVE STE 200, HINSDALE, IL 60521-2480
(312) 498-4409
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
IL
Other
Enumeration date
04/30/2018
Last updated
04/30/2018
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