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General NPI Number Information
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NPI Number | 1144726555
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Entity Type | Individual
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Provider Name | ROSS PEARLMAN
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Gender | Male
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Dates
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Enumeration Date | 04/04/2018
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Last Update Date | 07/02/2024
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Provider Practice Location Address
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Address Line | 363 W ERIE ST STE 350
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City | CHICAGO
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State | IL
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Zip | 60654-6933
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Country | US
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Telephone | 312-995-1955
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Fax |
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Provider Business Mailing Address
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Address Line | 13001 E 17TH PL
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City | AURORA
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State | CO
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Zip | 80045-2570
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0101X
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Taxonomy Name | MOHS-Micrographic Surgery Physician
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License Number | 036.161153
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License Number State | IL
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