Edgebrook Dermatology P.C.

LBN: Edgebrook Dermatology P.C.
Edgebrook Dermatology P.C. is an health care organization with primary practice located at 1639 N Alpine Rd , Rockford IL 61107-1449. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as the primary health care specialty. Edgebrook Dermatology P.C. can be contacted via phone (815) 229-9333, or through Albasha, Maria via phone (815) 229-9333.

Contact Information

Primary practice address
1639 N Alpine Rd Rockford IL 61107-1449
Phone: (815) 229-9333
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Albasha, Maria
Phone: (815) 229-9333

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X

Profile Details

NPI number 1225184948
LBN Legal business name Edgebrook Dermatology P.C.
DBA Doing business as
Authorized official Albasha, Maria
Entity Organization
Organization subpart 1 No
Enumeration date Jan 26th, 2007
Last updated Aug 22nd, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1225184948 NPPES
Illinois Other 10107770 BLUE SHIELD

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