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General NPI Number Information
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NPI Number | 1720844517
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Entity Type | Organization
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Legal Business Name | LK DERMATOLOGY, PLLC
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Dates
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Enumeration Date | 02/28/2024
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Last Update Date | 03/18/2024
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Provider Practice Location Address
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Address Line | 21 W 2ND ST
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City | HINSDALE
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State | IL
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Zip | 60521-1700
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Country | US
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Telephone | 630-463-9141
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Fax |
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Provider Business Mailing Address
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Address Line | 305 AMBRIANCE DR
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City | BURR RIDGE
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State | IL
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Zip | 60527-0803
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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 | PRESIDENT
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Name | DR. LANA KASHLAN
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Credential | MD
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Telephone | 812-243-1188
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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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