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Individual

DR. EDIDIONG KAMINSKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
3808 N LINCOLN AVE, STE 101, CHICAGO, IL 60613-6065
(773) 677-4300
Mailing address
3024 N ASHLAND AVE UNIT 577452, CHICAGO, IL 60657-7783
(901) 907-9820

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036.133070
IL
207N00000X
Dermatology Physician
136349
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1265073415
ORGANIZATIONAL NPI
Enumeration date
06/17/2009
Last updated
08/28/2023
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