Individual
DR. DEREK C ARCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22N285 PEPPER RD, SUITE #103, LAKE BARRINGTON, IL 60010-5982
(847) 732-2739
Mailing address
410 ROSEMARY RD, TORONTO, ONTARIO M5P 3-E5
(416) 617-0102
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
36084401
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-084401#1
—
IL
Enumeration date
10/04/2006
Last updated
09/18/2008
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