Provider profile · NPI 1861571051

Advanced Clinical & Surgical Dermatology

Dermatology · Naperville, IL · NPI 1861571051 · No federal exclusion match

✔ Verified against the public CMS NPPES registry & HHS-OIG LEIE as of Jun 21, 2026. Source-linked, daily-refreshed. Public data only — no PHI.

Registry details

Type

Organization

Primary specialty

Dermatology

Enumerated

Nov 6, 2006

License(s)

036-077825 (IL)

Addresses on file

PurposeAddressCity/StatePhone
MAILINGPO BOX 9504 Naperville, IL 60567-0504630-236-4315
LOCATION1012 95TH ST SUITE 1Naperville, IL 60564-5041630-236-4315

View on NPPES registry ↗

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