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General NPI Number Information
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NPI Number | 1639847700
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Entity Type | Organization
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Legal Business Name | SKINIO SERVICES, S.C.
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Dates
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Enumeration Date | 09/02/2021
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Last Update Date | 09/02/2021
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Provider Practice Location Address
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Address Line | 171 N ABERDEEN ST STE 400
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City | CHICAGO
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State | IL
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Zip | 60607-1670
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Country | US
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Telephone | 855-754-6400
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Fax |
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Provider Business Mailing Address
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Address Line | 171 N ABERDEEN ST STE 400
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City | CHICAGO
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State | IL
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Zip | 60607-1670
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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 | CEO
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Name | KYOKO CRAWFORD
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Credential |
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Telephone | 917-670-0821
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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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