Organization
AESTHETIC DERMATOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONITH Y BREADON M.D. (OWNER)
(773) 883-5300
Entity
Organization
Contact information
Practice address
2551 N CLARK ST, SUITE #201, CHICAGO, IL 60614-1798
(773) 883-5300
(773) 883-1807
Mailing address
2551 N CLARK ST, SUITE #201, CHICAGO, IL 60614-1798
(773) 883-5300
(773) 883-1807
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
IL
Other
Enumeration date
06/26/2006
Last updated
08/22/2020
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