Individual
JERRY FELDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1900 W POLK ST STE 519, CHICAGO, IL 60612-3723
(312) 864-4390
(312) 864-4390
Mailing address
6800 N CALIFORNIA AVE APT 4G, CHICAGO, IL 60645-4553
(773) 802-6352
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036-077856
IL
207ND0101X
MOHS-Micrographic Surgery Physician
036-077856
ID
Other
Enumeration date
11/21/2006
Last updated
04/23/2021
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