Provider Demographics
NPI:1346869393
Name:JULIA KATSNELSON MD SC
Entity Type:Organization
Organization Name:JULIA KATSNELSON MD SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JULIA
Authorized Official - Middle Name:V
Authorized Official - Last Name:KATSNELSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-303-8900
Mailing Address - Street 1:231 OLDE HALF DAY RD STE B
Mailing Address - Street 2:
Mailing Address - City:LINCOLNSHIRE
Mailing Address - State:IL
Mailing Address - Zip Code:60069-2931
Mailing Address - Country:US
Mailing Address - Phone:847-303-8900
Mailing Address - Fax:847-303-8989
Practice Address - Street 1:231 OLDE HALF DAY RD STE B
Practice Address - Street 2:
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-2931
Practice Address - Country:US
Practice Address - Phone:847-303-8900
Practice Address - Fax:847-303-8989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-04-10
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty