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NPI Code Detail

MEDICARE: AB DERMATOLOGY LLC

MEDICARE: AB DERMATOLOGY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology Physician

General Provider Information

NPI Number : 1285043646
Entity Type Code : Organization
Provider Name (Legal Business Name) : AB DERMATOLOGY LLC
Provider Business Mailing Address
First Line : 3060 N ARLINGTON HEIGHTS RD
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-1530
Country : US
Telephone Number : 847-394-1202
Fax Number : 847-394-3674
Provider Business Practice Location Address
First Line : 3060 N ARLINGTON HEIGHTS RD
Second Line :
City : ARLINGTON HEIGHTS
State : IL
Zip : 60004-1530
Country : US
Telephone Number : 847-394-1202
Fax Number : 847-394-3674
Authorized Official
Title or Position : DOCTOR
Name : SULEMAN BANGASH
Credential : D.O.
Telephone Number : 224-542-9942
Provider Enumeration Date : 08/10/2014
Last Update Date : 08/10/2014

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Directions to “AB DERMATOLOGY LLC ” Practice Location

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