Registry details
Type
Individual
Primary specialty
Dermatology
Enumerated
Mar 7, 2006
License(s)
036085199 (IL)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 2000 LAKE AVE | Woodstock, IL 60098-7401 | 815-337-7100 |
| LOCATION | 2000 LAKE AVE | Woodstock, IL 60098-7401 | 815-337-7100 |
Watch this provider
Get a webhook/email the day this provider is added to the OIG-LEIE exclusion list or appears in an FDA enforcement action.