Organization
ADVANCED SKIN AND MOHS SURGERY CENTER S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARENCE WILLIAM BROWN JR. M.D., J.D., F.A.A.D. (DIRECTOR)
(773) 294-0107
Entity
Organization
Contact information
Practice address
2845 N. SHERIDAN ROAD, STE 912, CHICAGO, IL 60657
(773) 281-0046
(773) 281-0228
Mailing address
2570 NILES RD, SAINT JOSEPH, MI 49085-3203
(269) 985-0021
(269) 281-0281
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
036096380
IL
Other
Enumeration date
03/08/2016
Last updated
12/22/2020
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