CRAIG D NEITZEL (NPI# 1275640617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275640617 |
| Entity Type | Individual |
| Full Name | CRAIG D NEITZEL |
| Credential | MD |
| Practice Address |
1701 W. Curtis Road Dermatology Champaign IL 61822 |
| Mailing Address |
611 W Park St Bwpc Urbana IL 61801-2529 |
| Practice Telephone | 2173656204 |
| Practice Fax Number | 2173261234 |
| Mailing Telephone | 2173836792 |
| Mailing Fax Number | 2173834752 |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2014-05-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 036101453 | IL | Allopathic & Osteopathic Physicians |
| Street Address |
1701 W. CURTIS ROAD DERMATOLOGY |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61822 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205866415 | Ines O Baquero | Obstetrics & Gynecology | 1701 W. Curtis Road, Ob/gyn, Champaign, IL 61822 | 2006-07-04 |
| 1669791166 | Sean Patrick Fullan | Pediatrics | 1701 W. Curtis Road, Champaign, IL 61822-9678 | 2010-05-24 |
| 1518195155 | William D. Holmes | Dermatology | 1701 W. Curtis Road, Champaign, IL 61822-9678 | 2009-06-22 |
| 1457590408 | Tina Yi-ting Yang | Family Medicine | 1701 W. Curtis Road, Champaign, IL 61822-9678 | 2009-02-16 |
| 1518158914 | Jody K Gurtler | Registered Nurse | 1701 W. Curtis Road, Pediatrics, Champaign, IL 61822 | 2007-08-09 |
| 1922159110 | Jeremy Medler | Physician Assistant | 1701 W. Curtis Road, Dermatology, Champaign, IL 61822 | 2007-01-15 |
| 1649347550 | Joyce S Rhee | Internal Medicine | 1701 W. Curtis Road, Adult Medicine, Champaign, IL 61822 | 2006-11-29 |
| 1518067743 | Gretchen B Sperka | Internal Medicine | 1701 W. Curtis Road, Adult Medicine, Champaign, IL 61822 | 2006-09-25 |
| 1710084124 | Paul R Wilson | Internal Medicine | 1701 W. Curtis Road, Adult Medicine, Champaign, IL 61822 | 2006-09-20 |
| 1891898110 | Janet W Welch | Internal Medicine | 1701 W. Curtis Road, Adult Medicine, Champaign, IL 61822 | 2006-09-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083180830 | Osf Multi-specialty Group | Non-Pharmacy Dispensing Site | 2718 N Prospect Avenue, Champaign, IL 61822 | 2018-10-19 |
| 1487129730 | Siegfred T. Celis | Occupational Therapy Assistant | 1820 Oak Park Drive, Champaign, IL 61822 | 2018-10-12 |
| 1134633746 | Osf Healthcare System | Home Health | 1501 Interstate Dr Ste C, Champaign, IL 61822 | 2017-11-20 |
| 1386164200 | Carlo Sandico | Physical Therapist | 612 Corey Lane, Champagne, IL 61822 | 2017-06-21 |
| 1295270288 | Jennifer Lee Lugo | Registered Nurse | 3101 Fields South Dr., Champaign, IL 61822 | 2016-12-29 |
| 1902341209 | Jala Simmons | Behavioral Analyst | 4112 Fieldstone Rd, Suite B, Champaign, IL 61822 | 2016-12-22 |
| 1639552433 | Muhammad Ajmal | Internal Medicine | 1701 Curtis Road, Carle Clinic, Champaign, IL 61822 | 2015-06-30 |
| 1518363761 | Margaret A. Hallden | Hearing Instrument Specialist | 3354 Big Pine Trail #c, Audibel Hearing Aids, Champaign, IL 61822 | 2014-11-17 |
| 1801291638 | Kristen Karlsen | Pharmacist | 3114 Village Office Place, Champaign, IL 61822 | 2014-10-22 |
| 1649601543 | Jeff Chu | Optometrist | 507 W. Town Center Blvd, Champaign, IL 61822 | 2013-12-03 |
| Find all providers in zip 61822 | ||||
| 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 |
|---|---|---|---|---|
| 1073951729 | Caitlyn Annice Foote | Dermatology | 101 W University Ave, Champaign, IL 61820-3981 | 2013-06-04 |
| 1154639508 | Kathryn Lee Serowka Lane | Dermatology | 101 W University Ave, Champaign, IL 61820-3981 | 2010-09-20 |
| 1518195155 | William D. Holmes | Dermatology | 1701 W. Curtis Road, Champaign, IL 61822-9678 | 2009-06-22 |
| 1972654515 | Hada Cosmetic Medicine LLC | Dermatology | 1 E Main St, Champaign, IL 61820-3654 | 2007-01-12 |
| 1417022161 | Eleni Moraites | Dermatology | 101 W University Ave, Champaign, IL 61820-3909 | 2006-11-21 |
| 1235240904 | Ann Tice | Dermatology | 1 E Main St, Suite 103, Champaign, IL 61820-3654 | 2006-08-31 |
| 1811903677 | Lester J. Fahrner | Dermatology | 101 W University Ave, Champaign, IL 61820-3909 | 2006-08-01 |
| 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 |
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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.