Organization
CONRAD PETERSEN DERMATOLOGY SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN PETERSEN MD (OWNER)
(314) 518-0403
Entity
Organization
Contact information
Practice address
2845 N SHERIDAN, CHICAGO, IL 60657
(773) 832-7443
(773) 295-4126
Mailing address
2845 N SHERIDAN, CHICAGO, IL 60657
(773) 832-7443
(773) 295-4126
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
04/02/2019
Last updated
03/19/2020
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