Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 036-114282 | IL |
NPI | 1023284635 |
---|---|
Provider Name | Dr. Melissa Lynn Abrams |
First Address | Vernon Hills, IL 60061-3120 |
Second Address | Vernon Hills, IL 60061-3120 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/05/2008 |
Last Update Date | 26/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036114282 | (05) | IL |