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Organization

VITALSKIN MEDICAL GROUP IL PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JEREMY SCOTT YOUSE MD (CHIEF MEDICAL DIRECTOR)
(415) 802-1310
Entity
Organization

Contact information

Practice address
1765 N ELSTON AVE STE 110, CHICAGO, IL 60642-1501
(773) 276-1100
Mailing address
1111 W KENYON RD, URBANA, IL 61801-1004
(415) 802-1310

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207ND0101X
MOHS-Micrographic Surgery Physician
207ND0900X
Dermatopathology Physician

Other

Enumeration date
03/08/2023
Last updated
07/03/2025
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