Organization
EDGEBROOK DERMATOLOGY, PC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA ALBASHA (PRESIDENT)
(815) 229-9333
Entity
Organization
Contact information
Practice address
1639 N ALPINE RD, ROCKFORD, IL 61107-1449
(815) 229-9333
Mailing address
PO BOX 1686, ROCKFORD, IL 61110-0186
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
12/14/2006
Last updated
08/22/2020
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