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Organization

COLE D LUNDQUIST MD SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
COLE D LUNDQUIST MD (MD)
(847) 590-1500
Entity
Organization

Contact information

Practice address
1875 DEMPSTER ST, SUITE 660, PARK RIDGE, IL 60068-1186
(847) 590-1500
(847) 590-1502
Mailing address
1875 DEMPSTER ST, SUITE 660, PARK RIDGE, IL 60068-1186
(847) 590-1500
(847) 590-1502

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036056878
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036056878
IL
Enumeration date
11/30/2010
Last updated
12/06/2010
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