Provider Type Icon

PHYSICIANS DERMPATH LABORATORY NPI 1376866897


NPI Information

NPI: 1376866897
Provider Name: PHYSICIANS DERMPATH LABORATORY
Classification: Dermatology - 207ND0900X
Entity Type: Organization

Specialization: Dermatopathology

CLIA Number: 14D2040755

Address:
1420 N. RENAISSANCE DR.
SUITE 204
PARK RIDGE, IL
ZIP 60068
Phone: (847) 768-2440
Get Directions

PHYSICIANS DERMPATH LABORATORY is a dermatopathology dermatology in Park Ridge, IL. The provider is a dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. PHYSICIANS DERMPATH LABORATORY NPI is 1376866897. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1420 N. RENAISSANCE DR.
SUITE 204
PARK RIDGE, IL
ZIP 60068-330
Phone: (847) 768-2440
Fax: (847) 768-2443

The provider's authorized official is David A. Lorber .
The authorized official title is President and has the following contact phone number (847) 675-9711.

The CLIA number assigned to this NPI record is 14D2040755 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/11/2010 and was last updated on 11/9/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207ND0900XDermatologyDermatopathologyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.