ADVANCED SKIN AND MOHS SURGERY CENTER S.C. (NPI# 1174984959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174984959 |
| Entity Type | Organization |
| Organization Name | ADVANCED SKIN AND MOHS SURGERY CENTER S.C. |
| Practice Address |
2845 N. Sheridan Road Ste 912 Chicago IL 60657 |
| Mailing Address |
171 W Goethe St Chicago IL 60610-1914 |
| Practice Telephone | 7732810046 |
| Practice Fax Number | 7732810228 |
| Mailing Telephone | 7732940107 |
| Mailing Fax Number | 8447315112 |
| Enumeration Date | 2016-03-08 |
| Last Update Date | 2020-07-31 |
| Authorized Official Name | DR. CLARENCE WILLIAM BROWN JR. (DIRECTOR) |
| Authorized Official Telephone | 7732940107 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
036096380 | IL | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2845 N. Sheridan Rd., Ste 912, Chicago, IL 60657 | 7732810046 | 7732810228 |
| Street Address |
2845 N. SHERIDAN ROAD STE 912 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982241386 | Illinois Bone and Joint Institute, LLC | Orthopaedic Surgery | 2845 N. Sheridan Road, Suite 6400, Chicago, IL 60657 | 2019-12-04 |
| 1245797364 | Megan Kathleen Niemiec | Nurse Practitioner | 2845 N. Sheridan Road, Suite 912, Chicago, IL 60657 | 2019-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303887 | Simone Paes | Behavior Technician | 3141 N Sheffield Ave, Chicago, IL 60657 | 2020-10-13 |
| 1821613175 | Samridhi Khatri | Internal Medicine | 836 W. Wellington Ave, Advocate Illinois Masonic Medica, Suite 1312, Chigaco, IL 60657 | 2020-06-12 |
| 1467074617 | Dewolfe Aesthetic Services Sc | Surgery | 3357 N. Southport Aveune, Chicago, IL 60657 | 2020-05-11 |
| 1790304657 | Mehr Amer Mjeed | Student in an Organized Health Care Education/Training Program | Advocate Internal Medicine Clinic, Advocate Illinois Ma, 836 West Wellington Avenue, Chicago, IL 60657 | 2020-04-10 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1306493408 | Art of Sight Eyecare, LLC | Optometrist | 2915 N. Broadway, Chicago, IL 60657 | 2019-08-22 |
| 1992359277 | Joseph Michael Rochford IIi | Counselor | 1358 W Belmont Ave, Unit # 202, Chicago, IL 60657 | 2019-07-25 |
| 1487116240 | Conrad Petersen Dermatology Sc | Dermatology | 2845 N Sheridan, Chicago, IL 60657 | 2019-04-02 |
| 1003388810 | Evolve Wellness S.c. | Counselor | 2845 North Sheridan Road, Suite 708, Chicago, IL 60657 | 2018-12-19 |
| 1639657414 | Advocate North Side Health Network | Psychiatric Unit | 836 W Wellington Ave., Chicago, IL 60657 | 2018-08-02 |
| Find all providers in zip 60657 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538200308 | Omeed Memar | Dermatology | 50 E Washington St Ste 200, Chicago, IL 60602-2154 | 2007-02-12 |
| 1891721965 | Aleksandar L Krunic | Dermatology | 5140 N California Ave Ste 660, Chicago, IL 60625-3664 | 2006-06-23 |
| 1437678133 | M D Aesthetics and Dermatology LLC | Dermatology | 1021 W Adams St, Ll # 1, Chicago, IL 60607-2934 | 2017-09-13 |
| 1588041099 | Sarah Jo Wilson | Dermatology | 676 N Saint Clair St Ste 1600, Chicago, IL 60611-2997 | 2015-05-04 |
| 1902933146 | Academic Dermatology & Skin Cancer Institute, Sc | Dermatology | 50 E Washington St Ste 200, Chicago, IL 60602-2154 | 2007-02-27 |
| 1801967633 | Aleksandar Krunic, Md, Sc | Dermatology | 5140 N California Ave Ste 660, Chicago, IL 60625-3664 | 2006-11-13 |
| 1306801246 | Northwestern Skin Cancer Institute, Ltd | Dermatology | 737 N Michigan Ave, Suite 2310, Chicago, IL 60611-2635 | 2006-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295374270 | Lilly Aesthetics Sc | Dermatology | 2500 S Highland Ave Ste 220, Lombard, IL 60148-7103 | 2019-12-23 |
| 1194270637 | University Dermatology and Vein Clinic LLC | Dermatology | 8110 Cass Ave, Darien, IL 60561-5013 | 2016-08-24 |
| 1376915629 | Forefront Dermatology, S.c. | Dermatology | 1520 Bond St, Naperville, IL 60563 | 2015-10-27 |
| 1710294756 | Tracy Campbell Md LLC | Dermatology | 675 W North Ave Ste 506, Melrose Park, IL 60160-1626 | 2010-09-13 |
| 1932388865 | Marsh Dermatology, Sc | Dermatology | 1252 American Way, Libertyville, IL 60048-3936 | 2007-10-27 |
| 1073595690 | Ashish C Bhatia | Dermatology | 550 E Devon Ave Ste 200, Itasca, IL 60143-2639 | 2005-11-18 |
| 1538153960 | Sharon Louise Horton | Dermatology | 1049 E Wilson St, Suite 190, Batavia, IL 60510-2474 | 2005-08-31 |
| 1487168258 | Oak Dermatology LLC | Dermatology | 550 E Devon Ave Ste 200, Itasca, IL 60143-2639 | 2017-11-30 |
| 1629524632 | Forefront Dermatology, S.c. | Dermatology | 3253 S Harlem Ave, Suite 1a, Berwyn, IL 60402 | 2016-08-30 |
| 1215383666 | Beaird Dermatology S C | Dermatology | 4885 Hoffman Blvd, Suite #407, Hoffman Estates, IL 60192-3726 | 2016-05-04 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.