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General NPI Number Information
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NPI Number | 1083563712
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Entity Type | Organization
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Legal Business Name | BIELINSKI DERMATOLOGY GROUP, LLC
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Dates
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Enumeration Date | 01/26/2026
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Last Update Date | 01/26/2026
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Provider Practice Location Address
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Address Line | 16105 S LA GRANGE RD
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City | ORLAND PARK
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State | IL
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Zip | 60467-5503
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Country | US
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Telephone | 708-636-3767
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Fax | 708-873-5849
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Provider Business Mailing Address
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Address Line | 16105 S LA GRANGE RD
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City | ORLAND PARK
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State | IL
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Zip | 60467-5503
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Country | US
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Telephone | 708-636-3767
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Fax | 708-873-5849
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | LAWRENCE LAZELLE ANDERSON
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Credential |
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Telephone | 903-521-6143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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