Organization
DERMATOLOGY AND MOHS SURGERY INSTITUTE, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DOUGLAS M LEONE M.D. (OWNER)
(309) 678-9596
Entity
Organization
Contact information
Practice address
3024 E EMPIRE ST, 2ND FLOOR, SUITE F, BLOOMINGTON, IL 61704-5402
(309) 678-9596
Mailing address
3024 E EMPIRE ST, 2ND FLOOR, SUITE F, BLOOMINGTON, IL 61704-5402
(309) 678-9596
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036.129240
IL
Other
Enumeration date
12/04/2012
Last updated
01/29/2013
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