Dermatology and Mohs Surgery Institute, Ltd.
NPI #1770828626 in Bloomington, Illinois
Provider Information
- NPI Number
- 1770828626
- Entity Type
- Organization
- Organization Name
- Dermatology and Mohs Surgery Institute, Ltd.
- Primary Specialty
- Specialist
- Enumeration Date
- Dec 4, 2012
- Last Updated
- Jan 29, 2013
Practice Location
- Address
- 3024 E EMPIRE ST
- Address 2
- 2ND FLOOR, SUITE F
- City
- Bloomington
- State
- Illinois
- ZIP Code
- 61704-5402
- Phone
- (309) 678-9596
Authorized Official
- Name
- DR. DOUGLAS M LEONE, M.D.
- Title
- OWNER
- Phone
- (309) 678-9596
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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