Organization
NORTH BRANCH DERMATOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELIZABETH N. FAHRENBACH M.D. (OWNER)
(847) 254-2193
Entity
Organization
Contact information
Practice address
7411 N MILWAUKEE AVE, NILES, IL 60714-3707
(773) 763-6000
(773) 763-6006
Mailing address
7411 N MILWAUKEE AVE, NILES, IL 60714-3707
(773) 763-6000
(773) 763-6006
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036133358
IL
Other
Enumeration date
08/26/2014
Last updated
08/26/2024
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