UNIVERSITY DERMATOLOGY (NPI# 1245566777) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245566777 |
| Entity Type | Organization |
| Organization Name | UNIVERSITY DERMATOLOGY |
| Other Organization Name | U OF DERMATOLOGY |
| Practice Address |
4605 Golf Rd Skokie IL 60076-1209 |
| Mailing Address |
Po Box 6029 Chicago IL 60680-6029 |
| Practice Telephone | 8476795199 |
| Practice Fax Number | 8476795490 |
| Mailing Telephone | 7732940107 |
| Mailing Fax Number | 2693105910 |
| Enumeration Date | 2009-10-18 |
| Last Update Date | 2009-11-19 |
| Authorized Official Name | DR. CLARENCE WILLIAM BROWN JR. (MANAGER) |
| Authorized Official Telephone | 7732940107 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 036113849 | IL | Allopathic & Osteopathic Physicians |
| N | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
036113849 | IL | Allopathic & Osteopathic Physicians |
| N | 207ND0900X |
Dermatology Specialization: Dermatopathology |
036113849 | IL | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
036113849 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 0360963803 | 05 |
| Other Name | Type Code |
|---|---|
| U of Dermatology | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346284551 | University Dermatology | Dermatology | 50 East Canfield St., Detroit, MI 48201 | 2006-06-16 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | UNIVERSITY DERMATOLOGY, INC. | 545 Barnhill Drive, Eh 139, Indianapolis, IN 46202 |
| Indiana Business Entities | UNIVERSITY DERMATOLOGY, P.C. | 550 N. University Blvd., Suite 3240, Indianapolis, IN 46202-5267 |
| Street Address |
4605 GOLF RD |
| City | SKOKIE |
| State | IL |
| Zip Code | 60076-1209 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699193334 | Benjamin C Garden | Dermatology | 4605 Golf Rd, Skokie, IL 60076 | 2014-03-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902456999 | Gateway Foundation, Inc | Clinic/Center | 4028 W. Dempster, Ste 100, Skokie, IL 60076 | 2019-09-12 |
| 1336798255 | Renee Rosenberg | Speech-Language Pathologist | C/o East Prairie School, 7616 N. East Prairie Road, Skoke, IL 60076 | 2019-09-04 |
| 1710531223 | Dw Care Solutions | Hospice Care, Community Based | 4556 Oakton St, Suite 205, Skokie, IL 60076 | 2019-08-01 |
| 1689228157 | Elaine Ng | Pharmacist | 9650 Gross Point Rd Suite 4900, Skokie, IL 60076 | 2019-08-01 |
| 1881169381 | Kathleen Pyles | Registered Nurse | 9650 Gross Point Rd # 4900, Skokie, IL 60076 | 2018-10-10 |
| 1174013452 | Vitae Health of Illinois LLC | Social Worker | 3450 Oakton St, Skokie, IL 60076 | 2018-05-13 |
| 1396253530 | Jodi Novick Okner | Social Worker | 9134 Kilbourn Avenue, Skokie, IL 60076 | 2018-01-22 |
| 1700335924 | Olumide Adeyemo | Nurse Practitioner | 4711 Golf Rd Suite 1250, Skokie, IL 60076 | 2016-09-28 |
| 1255705315 | Malka Rokach | Pharmacist | 3358 W Touhy, Skokie, IL 60076 | 2015-11-30 |
| 1578932620 | Katrina Margaret Keithley | Physician Assistant | 9669 Kenton Ave Ste 203, Skokie, IL 60076 | 2015-09-18 |
| Find all providers in zip 60076 | ||||
| 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 |
|---|---|---|---|---|
| 1447873831 | Derick Dermatology, LLC | Dermatology | 5250 Old Orchard Rd Ste 110, Skokie, IL 60077-4461 | 2020-05-20 |
| 1699193334 | Benjamin C Garden | Dermatology | 4605 Golf Rd, Skokie, IL 60076 | 2014-03-31 |
| 1285895003 | Nisha Desai | Dermatology | 9933 Woods Dr Ste 200, Skokie, IL 60077-1049 | 2008-06-24 |
| 1154448355 | Rush Pres St. Luke's Med Center | Dermatology | 4711 Golf Rd Ste 711, Skokie, IL 60076-1245 | 2007-03-23 |
| 1770634131 | Stephanie Mehlis | Dermatology | 9933 Woods Dr, 2nd Floor - Dermatology, Skokie, IL 60077-1057 | 2007-01-14 |
| 1437140530 | Alan Eugene Lasser | Dermatology | 4905 Old Orchard Ctr, Suite 318, Skokie, IL 60077-1425 | 2005-10-30 |
| 1326437039 | Lasser Dermatology, LLC | Dermatology | 4905 Old Orchard Ctr, Suite 318, Skokie, IL 60077-1458 | 2015-01-19 |
| 1104243070 | Jaime Beth Alexander | Dermatology | 9933 Woods Dr Ste 200, Skokie, IL 60077-1049 | 2014-03-27 |
| 1891021457 | Family Doctors/family Healthcare | Dermatology | 7100 Carpenter Rd, Skokie, IL 60077-3279 | 2009-11-02 |
| 1083947238 | Reshma Nair Haugen | Dermatology | 9977 Woods Dr, 2nd Floor, Skokie, IL 60077-1057 | 2009-09-04 |
| Find all providers in SKOKIE | ||||
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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.