Organization
DERMATOLOGY ASSOCIATES OF HINSDALE, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES O ERTLE M.D. (PHYSICIAN)
(630) 325-6880
Entity
Organization
Contact information
Practice address
333 CHESTNUT ST, SUITE 202, HINSDALE, IL 60521-3247
(630) 325-6880
(630) 325-5975
Mailing address
333 CHESTNUT ST, SUITE 202, HINSDALE, IL 60521-3247
(630) 325-6880
(630) 325-5975
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036-043180
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679695829
BCBSIL
IL
Enumeration date
04/06/2007
Last updated
09/16/2008
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