RUSH UNIVERSITY MEDICAL CENTER (NPI# 1396755096) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396755096 |
| Entity Type | Organization |
| Organization Name | RUSH UNIVERSITY MEDICAL CENTER |
| Other Organization Name | DERMATOLOGY PATIENT SERVICES |
| Practice Address |
6319 Fairview Ave Suite 102 Westmont IL 60559-2888 |
| Mailing Address |
1725 W Harrison St Ste 264 Chicago IL 60612-3844 |
| Practice Telephone | 6309684500 |
| Practice Fax Number | 6309684420 |
| Mailing Telephone | 3129422195 |
| Mailing Fax Number | 3125632263 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2013-09-09 |
| Authorized Official Name | MICHAEL D. THARP (DIRECTOR) |
| Authorized Official Telephone | 3129425000 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | RUSH UNIVERSITY MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Dermatology Patient Services | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306203583 | Rush University Medical Center | General Acute Care Hospital | 4536 N Greenview Ave Apt 2n, Chicago, IL 60640-5475 | 2016-01-19 |
| 1962762047 | Rush University Medical Center | Clinic/Center | 1321 S Paulina St, Chicago, IL 60608-1221 | 2012-05-22 |
| 1093036980 | Rush University Medical Center | Chronic Disease Hospital | 1615 Sea Breeze Ct, Munster, IN 46321-5106 | 2010-06-15 |
| 1598921991 | Rush University Medical Center | General Acute Care Hospital | 1645 W Jackson Blvd Ste 215, Chicago, IL 60612-3227 | 2008-08-05 |
| 1396906103 | Rush University Medical Center | Clinic/Center | 2245 W Jackson Blvd, Chicago, IL 60612-2910 | 2008-06-24 |
| 1972630861 | Rush University Medical Center | Clinic/Center | 730 N Pulaski Rd, Room 109 Orr School Base Health Center, Chicago, IL 60624-1063 | 2007-02-27 |
| 1184269425 | Rush University Medical Center | Radiology | 1620 W Harrison St, Chicago, IL 60612-3801 | 2019-11-11 |
| 1619518396 | Rush University Medical Center | Internal Medicine | 520 S. Maple Ave, 3 West, Oak Park, IL 60304-1022 | 2019-10-03 |
| 1801375696 | Rush University Medical Center | Dermatology | 2011 York Road, 2nd Floor, Oak Brook, IL 60523-1803 | 2018-08-13 |
| 1689165540 | Rush University Medical Center | Dermatology | 1411 S Michigan Ave, Chicago, IL 60605-2810 | 2018-05-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | RUSH UNIVERSITY MEDICAL CENTER | 600 S Paulina St, Aac 1020, Chicago, IL 60612-3806 |
| Colorado Business Entities | RUSH UNIVERSITY MEDICAL CENTER | 1201 Harrison St., Chicago, IL 60607 |
| Indiana Business Entities | RUSH UNIVERSITY MEDICAL CENTER | 1653 W Congress Pkwy, Chicago, IL 60612 |
| Indiana Business Entities | RUSH UNIVERSITY MEDICAL CENTER INC. | 5612 W 79th St, Burbank, IL 60459 |
| Street Address |
6319 FAIRVIEW AVE SUITE 102 |
| City | WESTMONT |
| State | IL |
| Zip Code | 60559-2888 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336391622 | Implant Solutions | Dentist | 6319 Fairview Ave, #103, Westmont, IL 60559-2888 | 2008-10-17 |
| 1992987697 | Dupage Internists Associates Ltd | Specialist | 6319 Fairview Ave, Suite 101, Westmont, IL 60559-2888 | 2007-12-04 |
| 1952436396 | Rajan Sharma, D.d.s., M.s.d., PC | Dentist | 6319 Fairview Ave, 103, Westmont, IL 60559-2888 | 2007-02-23 |
| 1841325271 | University Dental Associates | Dentist | 6319 Fairview Ave, #103, Westmont, IL 60559-2888 | 2007-02-23 |
| 1700911146 | The Dental Specialists | Dentist | 6319 Fairview Ave, 103, Westmont, IL 60559-2888 | 2007-02-23 |
| 1336159839 | Mary C Massa | Dermatology | 6319 Fairview Ave, Suite 102, Westmont, IL 60559-2888 | 2006-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598366874 | Rachel Stoffregen | Physical Therapist | 812 East Ogden Ave, Westmont, IL 60559 | 2020-11-04 |
| 1528672581 | Kera C Evans | Counselor | 414 Plaza Dr. Suite 301, Westmont, IL 60559 | 2020-09-06 |
| 1912403023 | Bianca J Dassinger | Social Worker | 750 Pasquinelli Drive, #204, Westmont, IL 60559 | 2018-04-05 |
| 1689192163 | Jeannie Marie Gorman | Nutritionist | 310 W. Burlington Ave, Westmont, IL 60559 | 2017-09-05 |
| 1326563248 | Bethany Juby | Psychologist | 825 N Cass Ave Ste 112, Westmont, IL 60559 | 2017-08-11 |
| 1861917189 | Marisa Raineri | Physical Therapist | 750 Pasquinelli Dr., #204, Westmont, IL 60559 | 2017-08-08 |
| 1093185209 | Kristin Kalivoda | Pharmacy Technician | 2 N. Cass Avenue, Westmont, IL 60559 | 2015-09-30 |
| 1780076679 | Katherine Celine Smith | Nurse Practitioner | 1010 Executive Drive, Suite 200, Westmont, IL 60559 | 2015-03-02 |
| 1841690898 | Kimberly Libby | Physical Therapist | 801 N Cass Ave Ste 100, Westmont, IL 60559 | 2014-08-27 |
| 1083036792 | Deborah Carsten | Counselor | 460 Quail Ridge Drive, Westmont, IL 60559 | 2014-01-15 |
| Find all providers in zip 60559 | ||||
| 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 |
|---|---|---|---|---|
| 1669524088 | Matthew Peter Olivo | Dermatology | 201 Haddon Ave, Westmont, NJ 08108-2860 | 2007-01-17 |
| 1336159839 | Mary C Massa | Dermatology | 6319 Fairview Ave, Suite 102, Westmont, IL 60559-2888 | 2006-08-08 |
| 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.