NICHOLAS BLICKENSTAFF (NPI# 1437544582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437544582 |
| Entity Type | Individual |
| Full Name | NICHOLAS BLICKENSTAFF |
| Credential | M.D., M.S. |
| Practice Address |
30 N Michigan Ave Ste 1429 Chicago IL 60602-3698 |
| Mailing Address |
7123 W Archer Ave Chicago IL 60638-2203 |
| Practice Telephone | 8157448554 |
| Mailing Telephone | 7086344602 |
| Mailing Fax Number | 6304951770 |
| Enumeration Date | 2015-04-04 |
| Last Update Date | 2020-02-24 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 036.150002 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
30 N MICHIGAN AVE STE 1429 |
| City | CHICAGO |
| State | IL |
| Zip Code | 60602-3698 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710539705 | Biyang Wang | Social Worker | 9 W Washington St, Chicago, IL 60602 | 2019-07-10 |
| 1538724349 | Megan Asta Sarasek | Social Worker | 134 N Lasalle Street, Suite 400, Chicago, IL 60602 | 2019-05-07 |
| 1659850691 | Sara Chen | Dentist | 105 West Madison, 3rd Floor, Chicago, IL 60602 | 2018-08-10 |
| 1942795059 | Pratiti Rajeshkumar Gandhi | Dentist | 33 N Dearborn St Ste 2400, Chicago, IL 60602 | 2018-06-30 |
| 1154833994 | Ywca Metropolitan Chicago | Counselor | 1 North Lasalle Street, Suite 1150, Chicago, IL 60602 | 2017-11-02 |
| 1013434620 | Michelle Malters | Counselor | 30 N Michigan Ave Ste 1909, Chicago, IL 60602 | 2017-08-24 |
| 1740729474 | Jd Manikowski, D.d.s., LLC | Health Maintenance Organization | 30 N. Michigan Ave #1520, Chicago, IL 60602 | 2017-02-14 |
| 1568909943 | Pratiksha Agrawal | Dentist | 105 W Madison St Fl 3, Chicago, IL 60602 | 2017-01-24 |
| 1790221521 | Anastasia Scangas | Social Worker | 30 N Michigan Ave Ste 826, Chicago, IL 60602 | 2017-01-18 |
| 1194269837 | Jenna Peterson | Psychologist | 111 N Wabash Ave Ste 822, Chicago, IL 60602 | 2016-12-15 |
| Find all providers in zip 60602 | ||||
| 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 |
|---|---|---|---|---|
| 1114551983 | Katherine Janezic | Dermatology | 7447 W Talcott Ave Ste 425, Chicago, IL 60631-3704 | 2020-03-02 |
| 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 |
| 1275013450 | Advanced Dermatology and Aesthetic Medicine | Dermatology | 850 S Wabash Ave Ste 200, Chicago, IL 60605-3642 | 2018-08-17 |
| 1346784543 | Dermio, LLC | Dermatology | 3023 N Clark St, Suite 861, Chicago, IL 60657-5200 | 2016-12-07 |
| 1366823544 | Oyinade Aderibigbe | Dermatology | 111 W Washington St Ste 1801, Chicago, IL 60602-3430 | 2015-06-14 |
| 1073909032 | Julia Dai | Dermatology | 5758 S Maryland Ave Fl 3, Chicago, IL 60637 | 2015-04-07 |
| 1801285929 | Medical Dermatology Associates of Chicago, Ltd | Dermatology | 363 W Erie St, Suite 350, Chicago, IL 60654-6903 | 2015-01-13 |
| 1366857286 | Noor Tazudeen | Dermatology | 4700 N Marine Dr Ste 220, Chicago, IL 60640-7972 | 2014-06-30 |
| 1780097105 | Michael Sotiriou | Dermatology | 1765 N Elston Ave Ste 110, Chicago, IL 60642 | 2014-06-03 |
| Find all providers in CHICAGO | ||||
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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.