UNITED SKIN SPECIALISTS ILLINOIS LTD, PC (NPI# 1194225268) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194225268 |
| Entity Type | Organization |
| Organization Name | UNITED SKIN SPECIALISTS ILLINOIS LTD, PC |
| Practice Address |
4107 S Water Tower Pl Mount Vernon IL 62864-6293 |
| Mailing Address |
2 Carlson Pkwy N Ste 240 Plymouth MN 55447-4485 |
| Practice Telephone | 6182440031 |
| Mailing Telephone | 7637460030 |
| Mailing Fax Number | 7633673677 |
| Enumeration Date | 2018-02-15 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | TRISHA NOETHE (CREDENTIALING) |
| Authorized Official Telephone | 7637460030 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
Allopathic & Osteopathic Physicians | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1054 Martin Luther King Dr, Centralia, IL 628013000 | 6182440031 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467955179 | United Skin Specialists Illinois Ltd, PC | Dermatology | 4107 S Water Tower Pl, Mount Vernon, IL 62864-6293 | 2018-03-09 |
| Street Address |
4107 S WATER TOWER PL |
| City | MOUNT VERNON |
| State | IL |
| Zip Code | 62864-6293 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215902986 | George T Nahass | Dermatology | 4107 S Water Tower Pl, Mount Vernon, IL 62864-6293 | 2006-02-17 |
| 1578039707 | Tina Hall | Registered Nurse | 4107 S Water Tower Pl, Mount Vernon, IL 62864-6293 | 2018-10-15 |
| 1467955179 | United Skin Specialists Illinois Ltd, PC | Dermatology | 4107 S Water Tower Pl, Mount Vernon, IL 62864-6293 | 2018-03-09 |
| 1083015689 | Natalie Amason | Dermatology | 4107 S Water Tower Pl, Mount Vernon, IL 62864 | 2014-09-15 |
| 1669599841 | Skin Care Center of Southern Il LLC | Dermatology | 4107 S Water Tower Pl, Mount Vernon, IL 62864-6293 | 2007-03-23 |
| 1669559290 | Marilyn Stombaugh | Physician Assistant | 4107 S Water Tower Pl, Mount Vernon, IL 62864-6293 | 2006-11-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619438892 | Melissa Pryer | Dietitian, Registered | 2020 Broadway, Suite 1, Mt. Vernon, IL 62864 | 2019-03-28 |
| 1487145454 | Chiropractic Wellness Center of Mt Vernon, LLC. | Chiropractor | 1009 S 42nd St Ste 5, Mount Vernon, IL 62864 | 2018-05-24 |
| 1851889208 | Kimberly Tate | Counselor | 4110 North Water Place, Mt. Vernon, IL 62864 | 2018-05-01 |
| 1871907790 | University Hematology Oncology Inc | Specialist | #11 Cusumano Professional Plaza, Mount Vernon, IL 62864 | 2014-06-18 |
| 1457771677 | Dynamic Counseling and Consultation Services | Social Worker | 3600 S Water Tower Pl, Mt Vernon, IL 62864 | 2014-04-27 |
| 1619239431 | Judith C Morgan | Counselor | 16338 N Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-06-08 |
| 1073888624 | James Brian Verges | Counselor | 16338 N. Illinois Hwy 37, Mount Vernon, IL 62864 | 2012-03-15 |
| 1720352271 | Lucinda M. Holdren | Counselor | 16338 North Illinois Highway 37, Mount Vernon, IL 62864 | 2012-03-01 |
| 1780978627 | Jamie M Orange | Physical Therapy Assistant | 19958 Fairfield Rd, Mt. Vernon, IL 62864 | 2011-06-08 |
| 1780978791 | Wendy Marie Claytor | Speech-Language Pathologist | 600 E Il Hwy 15, Mount Vernon, IL 62864 | 2011-06-07 |
| Find all providers in zip 62864 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811944309 | J Semmes Mickelwait | Dermatology | 1420 Roosevelt Ave, Suite 7, Mount Vernon, WA 98273-2687 | 2006-05-28 |
| 1083015689 | Natalie Amason | Dermatology | 4107 S Water Tower Pl, Mount Vernon, IL 62864 | 2014-09-15 |
| 1033533443 | Public Hospital Dist No 1 Skagit | Dermatology | 2320 Freeway Dr, Mount Vernon, WA 98273-5445 | 2014-02-06 |
| 1477865194 | Samuel M. Wilson | Dermatology | 2320 Freeway Drive, Skagit Regional Clinics-riverbend, Mount Vernon, WA 98273 | 2010-07-10 |
| 1750392403 | Claudette Hope Troyer | Dermatology | 107 W 4th St, Mount Vernon Neighborhood Health Center, Mount Vernon, NY 10550-4002 | 2006-08-10 |
| 1093733495 | Amber D Fowler | Dermatology | 1600 Continental Pl, Suite # 101, Mount Vernon, WA 98273-5607 | 2006-07-17 |
| 1114950375 | J Semmes Mickelwait Md Ps | Dermatology | 1420 Roosevelt Ave, Suite 7, Mount Vernon, WA 98273-2687 | 2006-07-09 |
| 1215923354 | Jerry D. Eisner | Dermatology | 1400 E. Kincaid St., Skagit Regional Clinics, Mount Vernon, WA 98274-4127 | 2005-09-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275141251 | Derick Dermatology, LLC | Dermatology | 239 Remington Boulevard, Suite 225, Bolingbrook, IL 60440 | 2020-07-16 |
| 1063030252 | Vitalskin Medical Group Il Pllc | Dermatology | 1111 W Kenyon Rd, Urbana, IL 61801-1010 | 2020-07-14 |
| 1447873831 | Derick Dermatology, LLC | Dermatology | 5250 Old Orchard Rd Ste 110, Skokie, IL 60077-4461 | 2020-05-20 |
| 1346869393 | Julia Katsnelson Md Sc | Dermatology | 231 Olde Half Day Rd, Lincolnshire, IL 60069-2906 | 2020-04-10 |
| 1114551983 | Katherine Janezic | Dermatology | 7447 W Talcott Ave Ste 425, Chicago, IL 60631-3704 | 2020-03-02 |
| 1013559400 | Orsini Surgical Dermatology Sc | Dermatology | 1519 Legacy Cir, Naperville, IL 60563-3161 | 2019-10-17 |
| 1124675244 | Kiracofe Md Medical, LLC | Dermatology | 719 South Blvd # 2903, Oak Park, IL 60302-2903 | 2019-08-22 |
| 1366009664 | Derick Dermatology | Dermatology | 1900 Spring Rd Ste 210, Oak Brook, IL 60523-9063 | 2019-05-22 |
| 1487116240 | Conrad Petersen Dermatology Sc | Dermatology | 2845 N Sheridan, Chicago, IL 60657 | 2019-04-02 |
| 1891257853 | Maria Estela Martinez Escala | Dermatology | 5841 S Maryland Ave Ste Mc5067, Chicago, IL 60637-1443 | 2019-04-01 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT VERNON |
| Zip Code | 62864 |
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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.