LORIS A TISOCCO (NPI# 1205896008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205896008 |
| Entity Type | Individual |
| Full Name | LORIS A TISOCCO |
| Credential | MD |
| Practice Address |
19 River Oaks Dr Calumet City IL 60409 |
| Mailing Address |
580 E Boughton Rd Ste A Bolingbrook IL 60440-2565 |
| Practice Telephone | 7088621290 |
| Practice Fax Number | 7088626447 |
| Mailing Telephone | 8157448554 |
| Mailing Fax Number | 6304951770 |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2020-01-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 036054667 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 200015120A | 05 |
| Street Address |
19 RIVER OAKS DR |
| City | CALUMET CITY |
| State | IL |
| Zip Code | 60409 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770966459 | Integrated Dermatology of Calumet City LLC | Dermatology | 19 River Oaks Dr, Calumet City, IL 60409-5802 | 2015-06-30 |
| 1922435023 | Maureen Quigley Wynne | Physician Assistant | 19 River Oaks Dr, Calumet City, IL 60409-5802 | 2013-10-03 |
| 1194860106 | Janet Biedron | Nurse Practitioner | 19 River Oaks Dr, Calumet City, IL 60409-5802 | 2007-02-20 |
| 1871502955 | Janice L. Keane | Nurse Practitioner | 19 River Oaks Dr, Calumet City, IL 60409-5802 | 2006-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689159832 | Victory Pharmacy of Decatur Inc | Pharmacy | 1837 River Oaks Rd, Calumet City, IL 60409 | 2018-10-03 |
| 1801336961 | It's About Change Sober Living, Inc. | Community/Behavioral Health | 1604 Horbor St., Calumet City, IL 60409 | 2017-03-08 |
| 1750832986 | Jeffrey Mcneil | Social Worker | 660 Memorial Dr., Calumet City, IL 60409 | 2016-10-24 |
| 1578855219 | Cherechi V Onyenso | Nurse Practitioner | 1473 Ring Ring Road, Great Heights Family Medicine, Calumet City, IL 60409 | 2011-05-13 |
| 1205097607 | Michael Peter Weisberg | Ophthalmology | 1700 East West Road, Calumet City, IL 60409 | 2008-06-19 |
| 1861694333 | County of Cook | Local Education Agency (LEA) | 1255 Superior Ave, Calumet City, IL 60409 | 2007-06-05 |
| 1689875585 | Calumet City School District #155 | Local Education Agency (LEA) | Memorial Dr and Superior, Calumet City, IL 60409 | 2007-05-29 |
| 1932224185 | Micah K Swansey Sr. | Psychologist | 593 Burnham Avenue, Calumet City, IL 60409 | 2007-03-20 |
| 1184768210 | Beverly Williamson | Optometrist | 200 River Oaks Drive, Calumet City, IL 60409 | 2007-02-20 |
| 1205978863 | Dillons Dental Services LLC | Dentist | 2000 E 159th St, Calumet City, IL 60409 | 2007-02-12 |
| Find all providers in zip 60409 | ||||
| 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 |
|---|---|---|---|---|
| 1770966459 | Integrated Dermatology of Calumet City LLC | Dermatology | 19 River Oaks Dr, Calumet City, IL 60409-5802 | 2015-06-30 |
| 1003915166 | Calumet Dermatology Assoc S C | Dermatology | 19 River Oaks Drive, Calumet City, IL 60409 | 2006-09-22 |
| 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 | CALUMET CITY |
| Zip Code | 60409 |
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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.