Provider Demographics
NPI:1093270324
Name:ASHIRA DERMATOLOGY LLC OF ASHIRA INDUSTRIES LLC
Entity Type:Organization
Organization Name:ASHIRA DERMATOLOGY LLC OF ASHIRA INDUSTRIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR/ DERMATOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANI
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:877-368-4270
Mailing Address - Street 1:1555 SHERMAN AVE STE 323
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-4421
Mailing Address - Country:US
Mailing Address - Phone:847-868-2655
Mailing Address - Fax:877-368-4270
Practice Address - Street 1:135 N GREENLEAF ST STE 204&209
Practice Address - Street 2:
Practice Address - City:GURNEE
Practice Address - State:IL
Practice Address - Zip Code:60031-3393
Practice Address - Country:US
Practice Address - Phone:877-368-4270
Practice Address - Fax:877-368-4270
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty