DEWOLFE AESTHETIC SERVICES SC (NPI# 1467074617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467074617 |
| Entity Type | Organization |
| Organization Name | DEWOLFE AESTHETIC SERVICES SC |
| Practice Address |
3357 N. Southport Aveune Chicago IL 60657 |
| Practice Telephone | 4342848770 |
| Practice Fax Number | 9142064144 |
| Mailing Telephone | 4342848770 |
| Mailing Fax Number | 9142064144 |
| Enumeration Date | 2020-05-11 |
| Last Update Date | 2020-05-11 |
| Authorized Official Name | JUDITH POLHEMUS (BILLING MANAGER) |
| Authorized Official Telephone | 4342848770 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| DeWolfe Aesthetic Services SC | Former Legal Business Name - Organization |
| Street Address |
3357 N. SOUTHPORT AVEUNE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60657 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992303887 | Simone Paes | Behavior Technician | 3141 N Sheffield Ave, Chicago, IL 60657 | 2020-10-13 |
| 1821613175 | Samridhi Khatri | Internal Medicine | 836 W. Wellington Ave, Advocate Illinois Masonic Medica, Suite 1312, Chigaco, IL 60657 | 2020-06-12 |
| 1790304657 | Mehr Amer Mjeed | Student in an Organized Health Care Education/Training Program | Advocate Internal Medicine Clinic, Advocate Illinois Ma, 836 West Wellington Avenue, Chicago, IL 60657 | 2020-04-10 |
| 1457997561 | Jasleen Mohini Singh | Physician Assistant | 1645a W School Street, Suite A, Clinic Entrance, Chicago, IL 60657 | 2019-11-24 |
| 1306493408 | Art of Sight Eyecare, LLC | Optometrist | 2915 N. Broadway, Chicago, IL 60657 | 2019-08-22 |
| 1992359277 | Joseph Michael Rochford IIi | Counselor | 1358 W Belmont Ave, Unit # 202, Chicago, IL 60657 | 2019-07-25 |
| 1487116240 | Conrad Petersen Dermatology Sc | Dermatology | 2845 N Sheridan, Chicago, IL 60657 | 2019-04-02 |
| 1003388810 | Evolve Wellness S.c. | Counselor | 2845 North Sheridan Road, Suite 708, Chicago, IL 60657 | 2018-12-19 |
| 1639657414 | Advocate North Side Health Network | Psychiatric Unit | 836 W Wellington Ave., Chicago, IL 60657 | 2018-08-02 |
| 1235627332 | Chicago Nephrology Associates, LLC | Internal Medicine | 3023 N Clark St #302, Chicago, IL 60657 | 2018-04-25 |
| Find all providers in zip 60657 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780198796 | Lin Plastic and Reconstructive Surgery Inc | Surgery | 730 W Couch Pl Unit 1409, Chicago, IL 60661-1383 | 2017-11-29 |
| 1952692717 | Georgios Kokosis | Surgery | 1725 W Harrison St Ste 425, Chicago, IL 60612-3893 | 2011-04-28 |
| 1427229129 | David Teplica | Surgery | 803 W Hutchinson St, Chicago, IL 60613-1616 | 2008-03-20 |
| 1629133459 | Mckay Mckinnon | Surgery | 680 N Lake Shore Dr Ste 1208, Chicago, IL 60611 | 2006-12-22 |
| 1629029426 | Arun Gosain | Surgery | 225 E Chicago Ave # 63, Chicago, IL 60611-2991 | 2006-05-15 |
| 1992790828 | Julia Corcoran | Surgery | 1801 W Taylor St, 3f Occ Mc 741, Chicago, IL 60612-4795 | 2005-09-16 |
| 1306447586 | Aesthetics Unlimited, Pllc | Surgery | 100 E Walton St Ste 400, Chicago, IL 60611-1448 | 2020-11-04 |
| 1558913921 | Byungjoon Jeon | Surgery | 5841 S Maryland Ave, Chicago, IL 60637-1443 | 2019-07-15 |
| 1821563545 | Pipeline - Weiss Medical Specialists, LLC | Surgery | 4646 N Marine Dr, Chicago, IL 60640-5759 | 2018-10-09 |
| 1902390198 | Anmol Chattha | Surgery | 5841 S Maryland Ave # Mc1052, Chicago, IL 60637-1443 | 2018-06-20 |
| 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.