Organization
NORTHWEST DERMATOLOGY, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEAN M. BACARELLA (OFFICE MANAGER)
(847) 884-8096
Entity
Organization
Contact information
Practice address
2500 W. HIGGINS ROAD, SUITE 1040, HOFFMAN ESTATES, IL 60169
(847) 884-8096
(847) 884-8125
Mailing address
2500 W. HIGGINS ROAD, SUITE 1040, HOFFMAN ESTATES, IL 60169
(847) 884-8096
(847) 884-8125
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001617988
BC/BS
IL
Enumeration date
07/21/2006
Last updated
08/22/2020
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