Organization
DERICK DERMATOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY DERICK M.D. (MEDICAL DIRECTOR)
(847) 381-8899
Entity
Organization
Contact information
Practice address
525 E CONGRESS PARKWAY, SUITE 200, CRYSTAL LAKE, IL 60014
(847) 381-8899
(847) 381-8999
Mailing address
PO BOX 6685, CAROL STREAM, IL 60197-6685
(847) 381-8899
(547) 381-8999
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
36112935
IL
332900000X
Non-Pharmacy Dispensing Site
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Other
Enumeration date
12/22/2016
Last updated
09/09/2022
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