Organization
TRACY CAMPBELL MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY CAMPBELL M.D. (SOLE PROPRIETOR)
(708) 450-5086
Entity
Organization
Contact information
Practice address
675 W NORTH AVE STE 506, MELROSE PARK, IL 60160-1626
(708) 450-5086
(708) 345-4075
Mailing address
675 W NORTH AVE STE 506, MELROSE PARK, IL 60160-1626
(708) 450-5086
(708) 345-4075
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036120737
IL
207ND0101X
MOHS-Micrographic Surgery Physician
036120737
IL
Other
Enumeration date
09/13/2010
Last updated
03/04/2011
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