LILLY AESTHETICS SC (NPI# 1295374270) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295374270 |
| Entity Type | Organization |
| Organization Name | LILLY AESTHETICS SC |
| Practice Address |
2500 S Highland Ave Ste 220 Lombard IL 60148-7103 |
| Mailing Address |
Po Box 644 Marquette MI 49855-0644 |
| Practice Telephone | 6303177338 |
| Enumeration Date | 2019-12-23 |
| Last Update Date | 2019-12-23 |
| Authorized Official Name | MERCY ODUEYUNGBO (PRESIDENT) |
| Authorized Official Telephone | 6303177338 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
2500 S HIGHLAND AVE STE 220 |
| City | LOMBARD |
| State | IL |
| Zip Code | 60148-7103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336778919 | Alish Kuply | Pharmacist | 2050 S Finley Rd Suite 20, Lombard, IL 60148 | 2020-04-06 |
| 1114567880 | Danielle Slansky | Speech-Language Pathologist | 401 N. Main St, Lombard, IL 60148 | 2020-01-10 |
| 1245715572 | Ellen Mary Corey | Behavior Technician | 627 S Grace St., Lombard, IL 60148 | 2018-10-02 |
| 1194204461 | Vip 2u, Inc | Internal Medicine | 477 E Butterfield Rd Ste 400, Lombard, IL 60148 | 2018-08-08 |
| 1881185684 | Samantha Lanagan | Behavior Technician | 21 W 356 Sidney Ave, Lombard, IL 60148 | 2018-05-29 |
| 1629570114 | Iris Victoria Goss | Hearing Instrument Specialist | 412 E. Roosevelt Rd, Lombard, IL 60148 | 2018-03-01 |
| 1780102350 | Richard Wong | Dentist | 845 S. Main St #300, Lombard, IL 60148 | 2017-09-05 |
| 1033637038 | Lora Lea Biesenkamp | Counselor | 450 E 22nd St Ste 150-17, Lombard, IL 60148 | 2017-08-30 |
| 1609392836 | Shafiq Ur Rehman | Specialist/Technologist, Other | 2005 South Finley Rd Unit 1012, Lombard, IL 60148 | 2017-08-18 |
| 1033642715 | Great Lakes Living Solutions Corp. | Home Health | 477 E. Butterfield Rd., Suite Ll005, Lombard, IL 60148 | 2017-04-09 |
| Find all providers in zip 60148 | ||||
| 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 |
|---|---|---|---|---|
| 1255358289 | Center for Dermatology and Skin Cancer Ltd | Dermatology | 2500 S Highland Ave, Suite 200, Lombard, IL 60148-5363 | 2006-07-16 |
| 1669403457 | Robert Vincent Kolbusz | Dermatology | 2500 S Highland Ave, Lombard, IL 60148-5363 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1487168258 | Oak Dermatology LLC | Dermatology | 550 E Devon Ave Ste 200, Itasca, IL 60143-2639 | 2017-11-30 |
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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.