Organization
BEAIRD DERMATOLOGY S C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE J M BEAIRD (OWNER)
(224) 484-0183
Entity
Organization
Contact information
Practice address
4885 HOFFMAN BLVD, SUITE #407, HOFFMAN ESTATES, IL 60192-3726
(224) 484-0183
Mailing address
PO BOX 3376, BARRINGTON, IL 60011-3376
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
207ND0900X
Dermatopathology Physician
—
—
207NI0002X
Clinical & Laboratory Dermatological Immunology Physician
—
—
207NP0225X
Pediatric Dermatology Physician
—
—
207NS0135X
Procedural Dermatology Physician
—
—
363AM0700X
Medical Physician Assistant
—
—
Other
Enumeration date
05/04/2016
Last updated
09/26/2019
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