Organization
DERICK DERMATOLOGY, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY JANE DERICK MD (MEDICAL DIRECTOR)
(847) 381-8899
Entity
Organization
Contact information
Practice address
12736 S STATE ROUTE 59 UNIT 102, PLAINFIELD, IL 60585-5461
(847) 381-8899
Mailing address
PO BOX 6685, CAROL STREAM, IL 60197-6685
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
Other
Enumeration date
06/02/2022
Last updated
09/09/2022
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