SOUTHWEST DERMATOLOGY (NPI# 1619260247) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619260247 |
| Entity Type | Organization |
| Organization Name | SOUTHWEST DERMATOLOGY |
| Practice Address |
1870 Silver Cross Boulevard Suite 250 New Lenox IL 60451 |
| Practice Telephone | 8154638989 |
| Practice Fax Number | 8154638948 |
| Mailing Telephone | 8154638989 |
| Mailing Fax Number | 8154638948 |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2011-06-21 |
| Authorized Official Name | CHEUK W YUNG (M.D./) |
| Authorized Official Telephone | 8154638989 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTHWEST DERMATOLOGY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | 36111373 | IL | Allopathic & Osteopathic Physicians |
| N | 207N00000X | Dermatology | 36116569 | IL | Allopathic & Osteopathic Physicians |
| Y | 207N00000X | Dermatology | 36059742 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518331420 | Southwest Dermatology | Dermatology | 6425 Nicollet Avenue South, Suite 202, Richfield, MN 55423-1668 | 2015-11-17 |
| 1770741860 | Southwest Dermatology | Dermatology | 410 W Main St, Ottawa, IL 61350-2802 | 2008-05-27 |
| Street Address |
1870 SILVER CROSS BOULEVARD SUITE 250 |
| City | NEW LENOX |
| State | IL |
| Zip Code | 60451 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770712531 | Advanced Eye Care Sc | Durable Medical Equipment & Medical Supplies | 1870 Silver Cross Boulevard, Suite110, New Lenox, IL 60451 | 2009-07-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871126227 | Forever Family Dental of New Lenox | Dentist | 202 Vancina Lane, New Lenox, IL 60451 | 2020-02-13 |
| 1699245662 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 115 East Maple St, New Lenox, IL 60451 | 2018-12-03 |
| 1093204778 | New Lenox Anesthesia LLC | Anesthesiology | 678 Cedar Crossing Dr, New Lenox, IL 60451 | 2018-05-08 |
| 1578068698 | My Medicar | Non-emergency Medical Transport (VAN) | 21625 S. Schoolhouse Rd, New Lenox, IL 60451 | 2018-03-29 |
| 1134646771 | Julianne M. Goudzwaard | Registered Nurse | 841 Buckboard Drive, New Lenox, IL 60451 | 2017-08-24 |
| 1063947422 | Silver Cross Ambulatory Surgery Center, LLC | Clinic/Center | 1003 Pawlak Parkway, New Lenox, IL 60451 | 2017-04-24 |
| 1386090041 | Lindsey Reimer | Speech-Language Pathologist | 3515 Golf Ave, New Lenox, IL 60451 | 2016-05-11 |
| 1295105484 | Alison Elaine Burchardt | Nurse Practitioner | 1890 Silver Cross Boulevard, Pavilion A, Suite 240, New Lenox, IL 60451 | 2015-09-30 |
| 1700278959 | Dental Professionals of Illinois, P.c | Dentist | 561 E Lincoln Hwy, New Lenox, IL 60451 | 2015-02-25 |
| 1912319146 | Teresea Bargewell | Counselor | 1049 E. Lincoln Hwy, Decision Point Counseling and Career Center, New Lenox, IL 60451 | 2014-05-22 |
| Find all providers in zip 60451 | ||||
| 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 |
|---|---|---|---|---|
| 1992098735 | Conor Patrick Dolehide | Dermatology | 1851 Silver Cross Blvd, Suite 150, New Lenox, IL 60451 | 2011-05-26 |
| 1003425836 | Dolehide Dermatology, S.c. | Dermatology | 1851 Silver Cross Blvd, Suite 150, New Lenox, IL 60451 | 2020-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275141251 | Derick Dermatology, LLC | Dermatology | 239 Remington Boulevard, Suite 225, Bolingbrook, IL 60440 | 2020-07-16 |
| 1063030252 | Vitalskin Medical Group Il Pllc | Dermatology | 1111 W Kenyon Rd, Urbana, IL 61801-1010 | 2020-07-14 |
| 1447873831 | Derick Dermatology, LLC | Dermatology | 5250 Old Orchard Rd Ste 110, Skokie, IL 60077-4461 | 2020-05-20 |
| 1346869393 | Julia Katsnelson Md Sc | Dermatology | 231 Olde Half Day Rd, Lincolnshire, IL 60069-2906 | 2020-04-10 |
| 1114551983 | Katherine Janezic | Dermatology | 7447 W Talcott Ave Ste 425, Chicago, IL 60631-3704 | 2020-03-02 |
| 1013559400 | Orsini Surgical Dermatology Sc | Dermatology | 1519 Legacy Cir, Naperville, IL 60563-3161 | 2019-10-17 |
| 1124675244 | Kiracofe Md Medical, LLC | Dermatology | 719 South Blvd # 2903, Oak Park, IL 60302-2903 | 2019-08-22 |
| 1366009664 | Derick Dermatology | Dermatology | 1900 Spring Rd Ste 210, Oak Brook, IL 60523-9063 | 2019-05-22 |
| 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 |
| Find all providers with the same taxonomy | ||||
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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.