Legacy Dermatology Pllc

NPI #1053024554 in Algonquin, Illinois

Provider Information

NPI Number: 1053024554
Entity Type: Organization
Organization Name: Legacy Dermatology Pllc
Primary Specialty: Dermatology
Enumeration Date: Dec 29, 2022
Last Updated: May 22, 2023

Practice Location

Address: 2230 HUNTINGTON DR N
City: Algonquin
State: Illinois
ZIP Code: 60102-4419
Phone: (415) 802-1310

Authorized Official

Name: LAURENCE BRADLEY, MD
Title: MD/OWNER
Phone: (415) 802-1310

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology - MOHS-Micrographic Surgery — MOHS-Micrographic Surgery	207ND0101X
Dermatology - Procedural Dermatology — Procedural Dermatology	207NS0135X
Dermatology	207N00000X	Primary

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Individual Providers

Provider Name	Specialty	City
Lauren Marie Boshnick, MD	Dermatology	Algonquin	AI Deep Dive
DR. Vikram J Khanna, MD	Dermatology	Algonquin	AI Deep Dive
DR. Laurence Martin Bradley JR., M.D.	Dermatology	Algonquin	AI Deep Dive
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Organizations

Provider Name	Specialty	City
Dermatology Specialists of Illinois, Ltd	Dermatology	Algonquin	AI Deep Dive

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