Diana Bolotin M.D.

NPI 1164746905 - Dermatology - 207ND0101X

NPI Details
NPI 1164746905
Gender Female
Enumeration Date 03/23/2010
Last Updated 03/23/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
5841 S MARYLAND AVE
MC 5067
CHICAGO IL, 60637-1447, US
Phone (773) 834-9821
Fax
Business Location
5841 S MARYLAND AVE
MC 5067
CHICAGO IL, 60637-1447, US
Phone (773) 834-9821
Fax
Toxanomy
Taxonomy Code 207ND0101X
License State Illinois
License Number 036.125194
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According to our database, Dr. Diana Bolotin M.D. NPI is 1164746905, taxonomy code is 207ND0101X and license number is 036.125194, license state is located at Illinois. Diana Bolotin M.D. physically located at 5841 S Maryland Ave, Chicago IL, 60637-1447. NPI Number Diana Bolotin M.D. has the Individual type.

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1164746905 NPI number is provided on an as is basis without warranty of any kind. 1164746905 is maintained by the National Plan & Provider Enumeration System. The contents of Diana Bolotin M.D. are for informational purposes only.