Organization
INNOVATIVE DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CANDACE M THRASH M.D. (DERMATOLOGIST)
(773) 907-8454
Entity
Organization
Contact information
Practice address
5140 N CALIFORNIA AVE, SUITE 660, CHICAGO, IL 60625-3645
(773) 907-8454
(773) 907-6336
Mailing address
5140 N CALIFORNIA AVE, SUITE 660, CHICAGO, IL 60625-3645
(773) 907-8454
(773) 907-6336
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
IL
Other
Enumeration date
06/10/2006
Last updated
08/22/2020
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