Provider Demographics
NPI:1285043646
Name:AB DERMATOLOGY LLC
Entity Type:Organization
Organization Name:AB DERMATOLOGY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:
Authorized Official - First Name:SULEMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BANGASH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:224-542-9942
Mailing Address - Street 1:3060 N ARLINGTON HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-1530
Mailing Address - Country:US
Mailing Address - Phone:847-394-1202
Mailing Address - Fax:847-394-3674
Practice Address - Street 1:3060 N ARLINGTON HEIGHTS RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-1530
Practice Address - Country:US
Practice Address - Phone:847-394-1202
Practice Address - Fax:847-394-3674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-10
Last Update Date:2014-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty