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Organization

STROW DERMATOLOGY LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
M ELIZABETH STROW (MD)
(217) 793-5517
Entity
Organization

Contact information

Practice address
2041 W ILES AVE, SPRINGFIELD, IL 62704-7005
(217) 793-5517
Mailing address
2041 W ILES AVE, SPRINGFIELD, IL 62704-7005
(217) 793-5517

Taxonomy

Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
779860
PROVIDER NUMBER
IL
Enumeration date
01/07/2008
Last updated
02/12/2008
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