Organization
SAMANTHA B. CONRAD M.D.S.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMANTHA B CONRAD M.D. (OWNER)
(847) 590-1500
Entity
Organization
Contact information
Practice address
360 W BUTTERFIELD RD, SUITE 240, ELMHURST, IL 60126-5068
(847) 590-1500
(847) 590-1500
Mailing address
1655 N ARLINGTON HEIGHTS RD, 203E, ARLINGTON HEIGHTS, IL 60004-3982
(847) 590-1500
(847) 590-1502
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036107758
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036107758
—
IL
Enumeration date
07/09/2012
Last updated
08/23/2012
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