Organization
QUIMBY DERMATOLOGY, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVEN R. QUIMBY M.D. (OWNER)
(309) 451-0214
Entity
Organization
Contact information
Practice address
1300 FRANKLIN AVE, SUITE 230B, NORMAL, IL 61761-3592
(309) 451-0214
(309) 451-8210
Mailing address
1300 FRANKLIN AVE, SUITE 230B, NORMAL, IL 61761-3592
(309) 451-0214
(309) 451-8210
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5721563
BLUE CROSS
IL
Enumeration date
07/26/2006
Last updated
08/22/2020
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