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General NPI Number Information
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NPI Number | 1437014735
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Entity Type | Organization
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Legal Business Name | MANDEL DERMATOLOGY CHICAGO PLLC
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Dates
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Enumeration Date | 12/18/2025
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Last Update Date | 12/18/2025
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Provider Practice Location Address
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Address Line | 150 E HURON ST STE 801
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City | CHICAGO
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State | IL
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Zip | 60611-2912
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Country | US
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Telephone | 312-395-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 45 NORTHERN BLVD
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City | GREENVALE
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State | NY
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Zip | 11548-1346
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Country | US
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Telephone | 312-395-7400
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. MITHCELL MANDEL
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Credential | MD
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Telephone | 646-350-4023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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