Provider Demographics
NPI:1609987171
Name:SCHAUMBURG DERMATOLOGY SC
Entity Type:Organization
Organization Name:SCHAUMBURG DERMATOLOGY SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PRASHANT
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGRI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-534-0700
Mailing Address - Street 1:911 N PLUM GROVE RD STE A
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60173-4793
Mailing Address - Country:US
Mailing Address - Phone:847-534-0700
Mailing Address - Fax:847-413-1818
Practice Address - Street 1:911 N PLUM GROVE RD STE A
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-4793
Practice Address - Country:US
Practice Address - Phone:847-534-0700
Practice Address - Fax:847-413-1818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036112126207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty