DERMATOLOGY ASSOCIATES LTD (NPI# 1386255123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386255123 |
| Entity Type | Organization |
| Organization Name | DERMATOLOGY ASSOCIATES LTD |
| Practice Address |
13401 S Ridgeland Ave Palos Heights IL 60463-1898 |
| Mailing Address |
18425 W Creek Dr Ste F Tinley Park IL 60477-6768 |
| Practice Telephone | 7084448300 |
| Mailing Telephone | 7084448300 |
| Enumeration Date | 2020-08-14 |
| Last Update Date | 2020-08-14 |
| Authorized Official Name | VIVEK IYENGAR (OWNER) |
| Authorized Official Telephone | 7084448300 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | DERMATOLOGY ASSOCIATES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 332900000X | Non-Pharmacy Dispensing Site | Suppliers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497968945 | Dermatology Associates Ltd | Non-Pharmacy Dispensing Site | 18425 W Creek Dr, Ste F, Tinley Park, IL 60477-6767 | 2007-05-08 |
| Street Address |
13401 S RIDGELAND AVE |
| City | PALOS HEIGHTS |
| State | IL |
| Zip Code | 60463-1898 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932756095 | Kim Rusiecki | Technician | 25 Parliament Drive East, Palos Heights, IL 60463 | 2019-08-23 |
| 1265925218 | Sentinel Anesthesia of Illinois, PC | Anesthesiology | 7340 W College Dr Fl 1, Palos Heights, IL 60463 | 2018-06-13 |
| 1225410848 | Deborah Ann Castaneda | Skilled Nursing Facility | 12350 Natchez Ave., Palos Heights, IL 60463 | 2015-06-19 |
| 1609253160 | Tareq Ayyad | Physical Therapy Assistant | 11730 Lighthouse Ln, Palos Heights, IL 60463 | 2015-05-04 |
| 1366846503 | Ryan Teahen | Dentist | 7600 W College Dr Ste 17, Palos Heights, IL 60463 | 2014-10-17 |
| 1295140309 | Paul Park | Ophthalmology | 7600 W College Dr Ste 9, Palos Heights, IL 60463 | 2014-06-26 |
| 1275976045 | Nazim A. Khan | Physician Assistant | 6450 West College Drive, Palos Heights, IL 60463 | 2013-04-11 |
| 1619246824 | Amanda M Ejka | Psychologist | 11800 South 75th Avenue, Suite 300, Palos Heights, IL 60463 | 2011-12-16 |
| 1578832937 | Sandi Maheras | Pharmacist | 1703 Spyglass Cir, Palos Heights, IL 60463 | 2011-12-14 |
| 1043597065 | Ashraf Olwan | Pharmacist | 7660 W Sequoia Rd, Palos Heights, IL 60463 | 2011-11-04 |
| Find all providers in zip 60463 | ||||
| Taxonomy Code | 332900000X |
| Grouping | Suppliers |
| Classification | Non-Pharmacy Dispensing Site |
| A site other than a pharmacy that dispenses medicinal preparations under the supervision of a physician to patients for self-administration. (e.g. physician offices, ER, Urgent Care Centers, Rural Health Facilities, etc.) |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013520113 | Pmr Illinois Holding, LLC | Non-Pharmacy Dispensing Site | 600 E Sibley Blvd, Dolton, IL 60419-2599 | 2020-08-28 |
| 1497398648 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 853 W Jackson Plaza, Morton, IL 61550 | 2019-10-21 |
| 1902449382 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 1730 Bradford Ln, Normal, IL 61761-1297 | 2019-10-18 |
| 1073173134 | Shobhana Patodia | Non-Pharmacy Dispensing Site | 1111 Superior St Ste 206, Melrose Park, IL 60160-4156 | 2019-06-19 |
| 1215494620 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 3653 N Vermilion Dr, Danville, IL 61832 | 2019-02-22 |
| 1306303714 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 520 N Cunningham Avenue, 5 Points Shopping Center, Urbana, IL 61802 | 2019-02-22 |
| 1124585534 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 5209 W. War Memorial Drive, Grand Prairie Mall, Peoria, IL 61615-9250 | 2019-02-22 |
| 1871050237 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 508 Iaa Dr, Bloomington, IL 61701-2216 | 2019-02-21 |
| 1518424969 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 2901 Columbus St, Ottawa, IL 61350-1009 | 2019-02-21 |
| 1386118057 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 263 Shuman Boulevard, Suite 125, Naperville, IL 60563 | 2019-01-16 |
| Find all providers with the same taxonomy | ||||
| City | PALOS HEIGHTS |
| Zip Code | 60463 |
Please comment or provide details below to improve the information on DERMATOLOGY ASSOCIATES LTD.
| 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.