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Organization

DERMATOLOGY SPECIALISTS OF ILLINOIS, LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VIKRAM KHANNA (PRESIDENT)
(847) 528-1177
Entity
Organization

Contact information

Practice address
2430 ESPLANADE DRIVE, SUITE B, ALGONQUIN, IL 60102
(212) 627-6515
Mailing address
2430 ESPLANADE DRIVE, SUITE B, ALGONQUIN, IL 60102

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
332900000X
Non-Pharmacy Dispensing Site

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1093219610
IL
Enumeration date
01/30/2015
Last updated
06/26/2023
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