14D2188778 CLIA NUMBER - SCOTT D GLAZER, MD - SC - GLAZER DERM - CHICAGO

Laboratory Demographics

CLIA Number: 14D2188778

Facility Name: SCOTT D GLAZER, MD - SC - GLAZER DERM - CHICAGO

Facility Address:
7447 W TALCOTT AVE - STE 321
CHICAGO, IL
ZIP 60631
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Facility Phone Number: 847 459-6611

Facility Type: Physician Office

Certificate Type: Waiver

NPI Number: 1770587206

Taxonomy: 207NS0135X - Dermatology
Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers).

CLIA Record

Field Name	Field Value
CLIA Number	14D2188778
LAB Type	Physician Office
Facility Name	SCOTT D GLAZER, MD - SC - GLAZER DERM - CHICAGO
Street	7447 W TALCOTT AVE - STE 321
City	CHICAGO
State	IL
ZIP	60631
Phone	847 459-6611
CertificateType	4
CertificateEffectiveDate	7/21/2022
CertificateExpirationDate	7/20/2024
FacilityType	Waiver

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This page was last updated on: 4/23/2024