Provider Demographics
NPI:1013559400
Name:ORSINI SURGICAL DERMATOLOGY SC
Entity Type:Organization
Organization Name:ORSINI SURGICAL DERMATOLOGY SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:PRIESS
Authorized Official - Last Name:ORSINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-300-0015
Mailing Address - Street 1:1519 LEGACY CIR
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-3161
Mailing Address - Country:US
Mailing Address - Phone:630-300-0015
Mailing Address - Fax:630-300-0014
Practice Address - Street 1:1519 LEGACY CIR
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-3161
Practice Address - Country:US
Practice Address - Phone:630-300-0015
Practice Address - Fax:630-300-0014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-17
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Single Specialty
No207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
No207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric DermatologyGroup - Single Specialty
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural DermatologyGroup - Single Specialty