VILLAGE DERMATOLOGY, SC (NPI# 1518210327) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518210327 |
| Entity Type | Organization |
| Organization Name | VILLAGE DERMATOLOGY, SC |
| Practice Address |
401 Linden Ave Wilmette IL 60091-2844 |
| Practice Telephone | 8479209177 |
| Practice Fax Number | 8479209188 |
| Mailing Telephone | 8479209177 |
| Mailing Fax Number | 8479209188 |
| Enumeration Date | 2012-10-17 |
| Last Update Date | 2012-10-17 |
| Authorized Official Name | DR. CECELIA H RICKETTS (OWNER) |
| Authorized Official Telephone | 8479209177 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261Q00000X | Clinic/Center | 042619944 | IL | Ambulatory Health Care Facilities |
| Street Address |
401 LINDEN AVE |
| City | WILMETTE |
| State | IL |
| Zip Code | 60091-2844 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689799454 | Cecelia H. Ricketts | Dermatology | 401 Linden Ave, Wilmette, IL 60091-2844 | 2007-03-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689284408 | Tanner Hoegh | Counselor | Address: 825 Green Bay Rd, Suite 200, Wilmette, IL 60091 | 2020-08-06 |
| 1205301082 | Charles Michael Falcone | Anesthesiology | 2743 Illinois Road, Wilmette, IL 60091 | 2018-10-09 |
| 1134646219 | Shari Beth Nivasch | Counselor | 445 Beverly Drive, Wilmette, IL 60091 | 2017-08-29 |
| 1508288440 | Debra Anne Brodd | Chiropractor | 522 Poplar, Wilmette, IL 60091 | 2014-01-13 |
| 1720411085 | Catherine Elizabeth Zwergel | Acupuncturist | 1215 Washington Ave Ste 203, Wilmette, IL 60091 | 2013-08-09 |
| 1447693106 | Michael Joseph Engelman | Dentist | 1625 Sheridan Rd. Suite M, Wilmette, IL 60091 | 2013-04-12 |
| 1720365117 | Anna Kielar | Pharmacist | 811 Greenbay Rd, Wilmette, IL 60091 | 2011-11-14 |
| 1306128368 | Victoriya Kharon | Pharmacist | 811 Greenbay Road, Wilmette, IL 60091 | 2011-09-15 |
| 1154626653 | Mary Jo Schmitz | Physical Therapist | 3330 Old Glenview Rd., Suite 4, Wilmette, IL 60091 | 2011-01-14 |
| 1053622522 | Stephanie Lynn Kutzen | Social Worker | 1925 Lake Avenue, Suite 305, Wilmette, IL 60091 | 2010-06-29 |
| Find all providers in zip 60091 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396977765 | Powers Physical Therapy LLC | Clinic/Center | 3545 Lake Ave, Suite 203, Wilmette, IL 60091-1058 | 2009-08-18 |
| 1437304946 | Beyer-powers Physical Therapy | Clinic/Center | 3545 Lake Ave, Suite 203, Wilmette, IL 60091-1058 | 2008-11-25 |
| 1447372248 | Ridgewellness Center | Clinic/Center | 901 Ridge Rd, Wilmette, IL 60091-1559 | 2007-04-04 |
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| 1013514298 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 1500 S Fairfield Ave Fl 4, Chicago, IL 60608-1782 | 2020-10-01 |
| 1841804879 | Chicago Poly Clinic LLC | Clinic/Center | 2446 W Devon Ave, Chicago, IL 60659-1913 | 2020-09-08 |
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| 1821607425 | Desired Medical Services Incorporated | Clinic/Center | 371 Mackinaw Ave, Calumet City, IL 60409-2524 | 2020-07-29 |
| 1639787823 | Md Infusions, Pllc | Clinic/Center | 666 Dundee Rd Ste 1800, Northbrook, IL 60062-2727 | 2020-07-14 |
| 1407474083 | Staten Family Practice Pllc | Clinic/Center | 500 W Virginia Ave, Gillespie, IL 62033-1025 | 2020-07-09 |
| 1629696679 | Serenity Internal Medicine & Wellness Center | Clinic/Center | 3330 W 177th St # 2d-1, Hazel Crest, IL 60429-2184 | 2020-07-07 |
| 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.