Midwest Dermpath LLC
NPI #1194591529 in Bartonville, Illinois
Provider Information
- NPI Number
- 1194591529
- Entity Type
- Organization
- Organization Name
- Midwest Dermpath LLC
- Primary Specialty
- Pathology - Dermatopathology
- Enumeration Date
- Nov 27, 2023
- Last Updated
- Jan 31, 2024
Practice Location
- Address
- 409 KELLER ST
- City
- Bartonville
- State
- Illinois
- ZIP Code
- 61607-2556
- Phone
- (309) 404-6583
Authorized Official
- Name
- TESFU HAILU, MD
- Title
- LAB DIRECTOR
- Phone
- (309) 404-6583
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pathology - Anatomic Pathology & Clinical Pathology — Anatomic Pathology & Clinical Pathology |
| Pathology - Dermatopathology — Dermatopathology |
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