Individual
DR. GORDON HARRIS DERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
1725 W HARRISON ST, SUITE 740, CHICAGO, IL 60612-3841
(312) 432-9200
(312) 432-9233
Mailing address
1725 W HARRISON ST, SUITE 740, CHICAGO, IL 60612-3841
(312) 432-9200
(312) 432-9233
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036055497
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036055497
—
IL
Enumeration date
05/24/2006
Last updated
07/18/2012
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