Organization
ACADEMIC & CLINICAL ASSOCIATES IN DERMATOLOGY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MORIA BERNSTEIN (ATTORNEY)
(708) 715-6848
Entity
Organization
Contact information
Practice address
7047 NORTH AVE, OAK PARK, IL 60302-1015
(708) 383-0300
Mailing address
7047 NORTH AVE, OAK PARK, IL 60302-1015
(708) 383-0300
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036035438
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01615155
BLUE CROSS BLUE SHIELD
IL
Enumeration date
04/19/2007
Last updated
11/12/2009
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