Innovative Dermatology

NPI #1154363844 in Chicago, Illinois

Provider Information

NPI Number: 1154363844
Entity Type: Organization
Organization Name: Innovative Dermatology
Primary Specialty: Dermatology
Enumeration Date: Jun 10, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 5140 N CALIFORNIA AVE
Address 2: SUITE 660
City: Chicago
State: Illinois
ZIP Code: 60625-3645
Phone: (773) 907-8454

Authorized Official

Name: DR. CANDACE M THRASH, M.D.
Title: DERMATOLOGIST
Phone: (773) 907-8454

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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