Elderderm Sc

NPI #1245577667 in Chicago, Illinois

Provider Information

NPI Number: 1245577667
Entity Type: Organization
Organization Name: Elderderm Sc
Primary Specialty: Dermatology
Enumeration Date: Jan 4, 2013
Last Updated: Jul 18, 2013

Practice Location

Address: 400 E RANDOLPH ST
Address 2: SUITE 2407
City: Chicago
State: Illinois
ZIP Code: 60601-7329
Phone: (312) 371-7517

Authorized Official

Name: DR. SCOTT BRENT PHILLIPS, M.D.
Title: PRESIDENT / CEO
Phone: (312) 371-7517

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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