DR. STEVEN JAY GOULDER (NPI# 1770560831) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770560831 |
| Entity Type | Individual |
| Full Name | DR. STEVEN JAY GOULDER |
| Credential | MD |
| Practice Address |
500 E Ogden Ave 200 Hinsdale IL 60521-2469 |
| Practice Telephone | 6303256647 |
| Practice Fax Number | 6303254500 |
| Mailing Telephone | 6303256647 |
| Mailing Fax Number | 6303254500 |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2012-09-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
036-108689 | IL | Allopathic & Osteopathic Physicians |
| N | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
036-108689 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 36108689 | 05 | |
| IL | MEDICARE | K09943 | 01 |
| Street Address |
500 E OGDEN AVE 200 |
| City | HINSDALE |
| State | IL |
| Zip Code | 60521-2469 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386256170 | Infinity Yoga LLC | Counselor | 702 Mills St, Hinsdale, IL 60521 | 2020-08-21 |
| 1427696855 | Anne Didier | Nurse Practitioner | 40 South Clay St., Suite 200, West Building, Hinsdale, IL 60521 | 2019-12-16 |
| 1619469244 | Rush Oak Brook Surgery Center, LLC | Clinic/Center | 2011 York Road, Suite 3000, Oak Brook, IL 60521 | 2018-05-30 |
| 1639680275 | Kelly M Lyell | Psychologist | 950 S Oak St, Hinsdale, IL 60521 | 2017-10-23 |
| 1386169720 | Elizabeth Ann Thorsness | Counselor | 412 East Fourth St., Hinsdale, IL 60521 | 2017-08-07 |
| 1275057424 | Bryndal Nicole Chervinko | Audiologist | 908 North Elm Street, Suite 306, Hinsdale, IL 60521 | 2017-07-31 |
| 1972038990 | Carolyn M Ball | Counselor | 19 N Grant St Ste 2c, Hinsdale, IL 60521 | 2017-04-27 |
| 1710429964 | Smiling Star Speech & Language | Speech-Language Pathologist | 120 E Odgen Avenue, Suite 110, Hinsdale, IL 60521 | 2016-11-04 |
| 1972964773 | Sharon Grob Murphy | Psychologist | 728 S. Park Ave., Hinsdale, IL 60521 | 2016-03-08 |
| 1992187074 | Matthew Destefani | Emergency Medicine | 109 Symonds Dr # 578, Hinsdale, IL 60521 | 2015-06-24 |
| Find all providers in zip 60521 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295374270 | Lilly Aesthetics Sc | Dermatology | 2500 S Highland Ave Ste 220, Lombard, IL 60148-7103 | 2019-12-23 |
| 1194270637 | University Dermatology and Vein Clinic LLC | Dermatology | 8110 Cass Ave, Darien, IL 60561-5013 | 2016-08-24 |
| 1174984959 | Advanced Skin and Mohs Surgery Center S.c. | Dermatology | 2845 N. Sheridan Road, Ste 912, Chicago, IL 60657 | 2016-03-08 |
| 1376915629 | Forefront Dermatology, S.c. | Dermatology | 1520 Bond St, Naperville, IL 60563 | 2015-10-27 |
| 1710294756 | Tracy Campbell Md LLC | Dermatology | 675 W North Ave Ste 506, Melrose Park, IL 60160-1626 | 2010-09-13 |
| 1932388865 | Marsh Dermatology, Sc | Dermatology | 1252 American Way, Libertyville, IL 60048-3936 | 2007-10-27 |
| 1538200308 | Omeed Memar | Dermatology | 50 E Washington St Ste 200, Chicago, IL 60602-2154 | 2007-02-12 |
| 1891721965 | Aleksandar L Krunic | Dermatology | 5140 N California Ave Ste 660, Chicago, IL 60625-3664 | 2006-06-23 |
| 1073595690 | Ashish C Bhatia | Dermatology | 550 E Devon Ave Ste 200, Itasca, IL 60143-2639 | 2005-11-18 |
| 1538153960 | Sharon Louise Horton | Dermatology | 1049 E Wilson St, Suite 190, Batavia, IL 60510-2474 | 2005-08-31 |
| 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.