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General NPI Number Information
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NPI Number | 1194225268
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Entity Type | Organization
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Legal Business Name | UNITED SKIN SPECIALISTS ILLINOIS LTD, PC
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Dates
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Enumeration Date | 02/15/2018
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Last Update Date | 08/16/2024
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Provider Practice Location Address
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Address Line | 4107 S WATER TOWER PL
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City | MOUNT VERNON
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State | IL
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Zip | 62864-6293
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Country | US
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Telephone | 618-244-0031
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Fax |
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Provider Business Mailing Address
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Address Line | 33 E 33RD ST FL 12
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City | NEW YORK
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State | NY
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Zip | 10016-5362
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Country | US
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Telephone | 212-283-3000
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ERIC S SCHWEIGER
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Credential | MD
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Telephone | 212-283-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ND0900X
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Taxonomy Name | Dermatopathology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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