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Organization

ELITE DERMATOLOGY PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EDWARD PRODANOVIC MD (OWNER)
(415) 802-1310
Entity
Organization

Contact information

Practice address
3000 N HALSTED ST STE 500, CHICAGO, IL 60657-5194
(773) 871-7000
Mailing address
3000 N HALSTED ST STE 500, CHICAGO, IL 60657-5194

Taxonomy

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

Other

Enumeration date
07/30/2026
Last updated
07/30/2026
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