Organization
KAMINSKA DERMATOLOGY PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDIDIONG KAMINSKA MD (MEDICAL DIRECTOR AND FOUNDER)
(773) 677-4300
Entity
Organization
Contact information
Practice address
3808 N LINCOLN AVE, SUITE 101, CHICAGO, IL 60613
(773) 677-4300
(773) 423-8429
Mailing address
3024 N ASHLAND AVE UNIT 577452, CHICAGO, IL 60657-7783
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407083496
INDIVIDUAL NPI
—
Enumeration date
09/30/2019
Last updated
08/28/2023
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