DERICK DERMATOLOGY, LLC (NPI# 1386118057) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386118057 |
| Entity Type | Organization |
| Organization Name | DERICK DERMATOLOGY, LLC |
| Practice Address |
263 Shuman Boulevard Suite 125 Naperville IL 60563 |
| Mailing Address |
Po Box 6685 Carol Stream IL 60197-6685 |
| Practice Telephone | 8473818899 |
| Practice Fax Number | 8473818999 |
| Mailing Telephone | 8473818899 |
| Mailing Fax Number | 8473818999 |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2019-04-12 |
| Authorized Official Name | AMY DERICK (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 8473818899 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332900000X | Non-Pharmacy Dispensing Site | Suppliers | ||
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275141251 | Derick Dermatology, LLC | Dermatology | 239 Remington Boulevard, Suite 225, Bolingbrook, IL 60440 | 2020-07-16 |
| 1447873831 | Derick Dermatology, LLC | Dermatology | 5250 Old Orchard Rd Ste 110, Skokie, IL 60077-4461 | 2020-05-20 |
| 1225526627 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 820 W Bartlett Rd, Bartlett, IL 60103-4402 | 2018-05-01 |
| 1851889257 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 8501 W Higgins Rd Ste 100, Chicago, IL 60631-2814 | 2018-05-01 |
| 1891283669 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 353 Bank Dr Ste 400, Mchenry, IL 60050-0506 | 2018-04-27 |
| 1639670904 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 750 W Lake Cook Rd Ste 270, Buffalo Grove, IL 60089-2069 | 2018-02-22 |
| 1386180198 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 1531 S Grove Avenue, Suite 101, Barrington, IL 60010 | 2017-01-18 |
| 1134664402 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 525 E Congress Parkway, Suite 200, Crystal Lake, IL 60014 | 2016-12-22 |
| 1497792618 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 85 W Algonquin Road, Suite 220, Arlington Heights, IL 60005 | 2006-05-31 |
| 1376017038 | Derick Dermatology, LLC | Non-Pharmacy Dispensing Site | 1025 Red Oak Lane, Suite 250, Lindenhurst, IL 60046 | 2019-01-16 |
| Street Address |
263 SHUMAN BOULEVARD SUITE 125 |
| City | NAPERVILLE |
| State | IL |
| Zip Code | 60563 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952902884 | Julia Ann Gottschalk | Nurse Practitioner | 1979 Mcdowell Rd, Unit 103, Naperville, IL 60563 | 2020-11-06 |
| 1700484847 | Lee Michael Harms I | Social Worker | 1952 Mcdowell Road, Suite 305, Naperville, IL 60563 | 2020-10-12 |
| 1881208478 | Poornima Swamy Gangaji | Dentist | 760 N, Illinois Rte 59, Ste100, Naperville, IL 60563 | 2020-09-01 |
| 1851901219 | Adiana Lebron | Social Worker | 2948 Artestian Road, Naperville, IL 60563 | 2020-07-31 |
| 1194342014 | Ingrid Lara | Behavioral Analyst | 1975 Mcdowell Rd #101, Naperville, IL 60563 | 2020-06-26 |
| 1396383030 | Jack Kelly | Assistant Behavior Analyst | 1975 Mcdowell Rd. #101, Naperville, IL 60563 | 2019-12-12 |
| 1316583529 | Arvind Ramakrishnan | Behavioral Analyst | 1975 Mcdowell Rd., Naperville, IL 60563 | 2019-11-22 |
| 1679115778 | Melissa Macias | Behavioral Analyst | 1975 Mcdowell Road, #101, Naperville, IL 60563 | 2019-10-10 |
| 1629619275 | Meghann Reid Vizintos | Physician Assistant | 1763 Freedom Dr Ste 117, Naperville, IL 60563 | 2019-10-04 |
| 1417413543 | Vikram Singh Cheema | Physician Assistant | 1335 North Mill Street, Naperville, IL 60563 | 2019-02-13 |
| Find all providers in zip 60563 | ||||
| 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 |
|---|---|---|---|---|
| 1013559400 | Orsini Surgical Dermatology Sc | Dermatology | 1519 Legacy Cir, Naperville, IL 60563-3161 | 2019-10-17 |
| 1245716042 | Basko Dermatology LLC | Dermatology | 1331 W 75th St Ste 402, Naperville, IL 60540-9336 | 2018-07-14 |
| 1235364092 | Shruthi Geedipalley Reddy | Dermatology | 640 S Washington St Ste 350, Naperville, IL 60540-6785 | 2009-05-22 |
| 1598987307 | Kelly J. Stankiewicz | Dermatology | 2155 City Gate Ln Ste 225, Naperville, IL 60563-7770 | 2007-05-02 |
| 1588743439 | Moira C Ariano, Md PC | Dermatology | 2323 Naperville Rd, Suite 120, Naperville, IL 60563-3444 | 2006-11-03 |
| 1083609028 | Kathleen Ann Remlinger | Dermatology | 636 Raymond Dr Ste 200, Naperville, IL 60563-9791 | 2005-09-15 |
| 1710328851 | Mariam Mafee | Dermatology | 2155 City Gate Ln Ste 225, Naperville, IL 60563 | 2013-07-16 |
| 1740523539 | Jill Katherine Cotseones | Dermatology | 636 Raymond Dr, Naperville, IL 60563 | 2013-04-01 |
| 1295086742 | Juliana Llazar Basko-plluska | Dermatology | 1331 W 75th St, Suite 402, Naperville, IL 60540-9336 | 2012-09-24 |
| 1720366636 | Lauren Nicole Taglia | Dermatology | 636 Raymond Dr, Naperville, IL 60563-9791 | 2011-07-26 |
| Find all providers in NAPERVILLE | ||||
| City | NAPERVILLE |
| Zip Code | 60563 |
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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.