Skin Care Center Of Southern Il Llc
LBN: Skin Care Center Of Southern Il Llc
Skin Care Center Of Southern Il Llc is an health care organization with primary practice located at 4107 S Water Tower Pl , Mount Vernon IL 62864-6293. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatopathology, which is considered as the primary health care specialty.
Skin Care Center Of Southern Il Llc can be contacted via phone (618) 244-0031, or through Nahass, George Thomas via phone (618) 244-0031.
Contact Information
Primary practice address
4107 S Water Tower Pl
Mount Vernon IL 62864-6293
Phone: (618) 244-0031
Fax: (618) 244-0056
Website:
Authorized official contact:
Name: Nahass, George Thomas Doctor of Medicine (MD)
Phone: (618) 244-0031
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatopathology | 207ND0900X | 036094700 | Illinois |
Profile Details
| NPI number | 1669599841 |
|---|---|
| LBN Legal business name | Skin Care Center Of Southern Il Llc |
| DBA Doing business as | |
| Authorized official | Nahass, George Thomas Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Mar 23rd, 2007 |
| Last updated | Jun 25th, 2013 - about 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669599841 | NPPES |
| Illinois | MEDICAID | 152566974412 | |
| Illinois | Other | CH5023 |
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