Advanced Dermatology Clinic, Inc.

NPI #1881167278 in Freeport, Illinois

Provider Information

NPI Number: 1881167278
Entity Type: Organization
Organization Name: Advanced Dermatology Clinic, Inc.
Subpart: Yes (part of a larger organization)
Parent Organization: ADVANCED DERMATOLOGY, INC.
Primary Specialty: Dermatology
Enumeration Date: Jan 8, 2019
Last Updated: Jun 10, 2020

Practice Location

Address: 1036 W STEPHENSON ST
City: Freeport
State: Illinois
ZIP Code: 61032-4865
Phone: (888) 423-7880

Authorized Official

Name: DR. HARRY SHARATA, MD
Title: MEDICAL DIRECTOR
Phone: (608) 826-0285

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dermatology	207N00000X	Primary

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