M D AESTHETICS AND DERMATOLOGY LLC


Address: 1021 W Adams St, Ll # 1, Chicago, IL 60607-2934
Phone: (312) 579-0700

M D AESTHETICS AND DERMATOLOGY LLC (NPI# 1437678133) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1437678133
Entity Type Organization
Organization Name M D AESTHETICS AND DERMATOLOGY LLC
Practice Address 1021 W Adams St
Ll # 1
Chicago
IL 60607-2934
Mailing Address 1021 W. Adams St.
Ll #1
Chicago
IL 60607
Practice Telephone (312) 579-0700
Practice Fax Number 3125790701
Mailing Telephone 3125790700
Mailing Fax Number 3125790701
Enumeration Date 2017-09-13
Last Update Date 2017-10-16
Authorized Official Name DR. GABRIEL J. MARTINEZ-DIAZ (MEDICAL DIRECTOR/DERMATOLOGIST)
Authorized Official Telephone 3125790700
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207ND0101X Dermatology
Specialization: MOHS-Micrographic Surgery
036138747 IL Allopathic & Osteopathic Physicians
N 207NS0135X Dermatology
Specialization: Procedural Dermatology
036138747 IL Allopathic & Osteopathic Physicians
Y 207N00000X Dermatology 036138747 IL Allopathic & Osteopathic Physicians

Office Location

Street Address 1021 W ADAMS ST
LL # 1
City CHICAGO
State IL
Zip Code 60607-2934

Providers in the same location

NPI Name Taxonomy Address Enumeration
1750414850 Resurrection Health Care Preferred Health Maintenance Organization 1021 W Adams St, Suite 300, Chicago, IL 60607-2934 2007-03-14
1811121908 Nancy Ann Diettrich Surgery 1021 W Adams St, 300, Chicago, IL 60607-2934 2009-05-05
1033318712 Resurrection Health Care Preferred Health Maintenance Organization 1021 W Adams St, Suite 300, Chicago, IL 60607-2934 2007-07-13

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1992349237 Portia Dowd Registered Nurse 140 N Ashland, Chicago, IL 60607 2019-10-30
1114577210 Joseph Matthew Thiel Emergency Medical Technician, Intermediate 558 West De Koven, Chicago, IL 60607 2019-09-19
1215585757 Highland Park Cvs LLC Durable Medical Equipment & Medical Supplies 1034 West Lake St, Chicago, IL 60607 2019-08-28
1003462821 Michael Marek Maka Psychologist 820 W. Jackson Blvd, Suite 515, Chicago, IL 60607 2019-08-16
1558922344 Kellie Meyer Speech-Language Pathologist Eyas Landing West Loop, 1409 W. Carroll Ave, Chicago, IL 60607 2019-06-24
1811460108 Corinna House Social Worker 932 W Washington, Chicago, IL 60607 2019-01-09
1962979518 Louise Taussig Bush Counselor 1142 West Madison Street, Suite 406, Chicago, IL 60607 2018-10-31
1568941318 Walgreen Co Durable Medical Equipment & Medical Supplies 1051 W Randolph, Chicago, IL 60607 2018-08-13
1851883425 Alefiyah Zulfiqar Pishori Psychologist 1200 West Harrison St, Chicago, IL 60607 2018-05-30
1679062954 Elizabeth R Rolston Physical Therapist 24 S Morgan St Ste 100, Chicago, IL 60607 2018-05-02
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Taxonomy Information

Taxonomy Code 207N00000X
Grouping Allopathic & Osteopathic Physicians
Classification Dermatology

Taxonomy Definition

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.

Providers in the same taxonomy and city

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
1437544582 Nicholas Blickenstaff Dermatology 30 N Michigan Ave Ste 1429, Chicago, IL 60602-3698 2015-04-04
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
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Competitor

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City CHICAGO
Zip Code 60607

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Dataset Information

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.

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