Organization
MILLENNIUM PARK DERMATOLOGY, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTORIA BARBOSA M.D. (PHYSICIAN OWNER)
(312) 407-0000
Entity
Organization
Contact information
Practice address
30 N MICHIGAN AVE, SUITE 1429, CHICAGO, IL 60602-3402
(312) 407-0000
(312) 407-0001
Mailing address
30 N MICHIGAN AVE, SUITE 1429, CHICAGO, IL 60602-3402
(312) 407-0000
(312) 407-0001
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036106254
IL
Other
Enumeration date
09/01/2010
Last updated
09/01/2010
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