DERMATOLOGY AND MOHS SURGERY INSTITUTE LTD. NPI 1770828626

NPI Information

DERMATOLOGY AND MOHS SURGERY INSTITUTE, LTD. is a specialist in Bloomington, IL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DERMATOLOGY AND MOHS SURGERY INSTITUTE, LTD. NPI is 1770828626. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3024 E EMPIRE ST
2ND FLOOR, SUITE F
BLOOMINGTON, IL
ZIP 61704-402
Phone: (309) 678-9596

The provider's authorized official is Douglas M Leone .
The authorized official title is Owner and has the following contact phone number (309) 678-9596.

The CLIA number assigned to this NPI record is 14D2054063 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 12/4/2012 and was last updated on 1/29/2013.

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:

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