Individual
JAMES SWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, (321 LAGRANGE RD., LAGRANDE PARK, IL.60526), MAYWOOD, IL 60153-3328
(708) 485-1020
(708) 485-1173
Mailing address
2160 S 1ST AVE, (321 LAGRANGE RD., LAGRANDE PARK, IL.60526), MAYWOOD, IL 60153-3328
(708) 485-1020
(708) 485-1173
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
36063593
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36063593
—
IL
Enumeration date
01/11/2006
Last updated
03/05/2010
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