Organization
CENTER FOR DERMATOLOGY AND SKIN CANCER LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT VICTOR KOLBUSZ M.D (OWNER)
(630) 964-2000
Entity
Organization
Contact information
Practice address
2500 S HIGHLAND AVE, SUITE 200, LOMBARD, IL 60148-5363
(630) 964-2000
(630) 964-6378
Mailing address
2500 S HIGHLAND AVE, SUITE 200, LOMBARD, IL 60148-5363
(630) 964-2000
(630) 964-6378
Taxonomy
Speciality
Code
Description
License number
State
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02207012
BCBS
IL
Enumeration date
07/16/2006
Last updated
04/04/2013
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