Organization
ADVANCED DERMATOLOGY CLINIC, INC.
Active
Parent organization
ADVANCED DERMATOLOGY, INC.
Organization subpart
Yes
Provider details
NPI number
Legal business name
ADVANCED DERMATOLOGY, INC.
Authorized official
DR. HARRY SHARATA MD (MEDICAL DIRECTOR)
(608) 826-0285
Entity
Organization
Contact information
Practice address
1036 W STEPHENSON ST, FREEPORT, IL 61032-4865
(888) 423-7880
(608) 826-0281
Mailing address
6510 GRAND TETON PLZ STE 302, MADISON, WI 53719-1029
(608) 826-0285
(608) 826-0281
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Enumeration date
01/08/2019
Last updated
06/10/2020
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