OrganizationLasser Dermatology, LlcDermatologyAllopathic & Osteopathic PhysiciansPractice Address4905 Old Orchard Ctr, Suite 318, Skokie, IL 60077-1458(847) 674-1570(708) 636-3767PECOS EnrollmentBased on the most recent information from CMS, provider Lasser Dermatology, Llc does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 4 days ago.Profile DetailsProvider ID1326437039Provider TypeOrganizationFull NameLasser Dermatology, LlcSubpartNoEnumeration Date1/19/2015Last Updated1/19/2015Contact InformationPractice LocationPractice Address4905 Old Orchard Ctr, Suite 318, Skokie, IL 60077-1458Phone(847) 674-1570Fax(847) 674-1517Mailing LocationMailing Address16105 S La Grange Rd, Orland Park, IL 60467-5503Phone(708) 636-3767Fax(708) 636-4361Authorized OfficialNameBielinski, Kenneth B (Owner)Phone(708) 636-3767Provider TaxonomiesCodeDescriptionLicenseCode207N00000XPrimaryDescriptionDermatologyAllopathic & Osteopathic PhysiciansLicense036070977Illinois