DR. LUCIUS C EARLES (NPI# 1689667479) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689667479 |
| Entity Type | Individual |
| Full Name | DR. LUCIUS C EARLES |
| Credential | M.D. |
| Practice Address |
9831 S Western Ave Chicago IL 60643-1740 |
| Mailing Address |
701 Lee St Suite 300 Des Plaines IL 60016-4539 |
| Practice Telephone | 7734453500 |
| Mailing Telephone | 8473905900 |
| Enumeration Date | 2005-08-26 |
| Last Update Date | 2012-12-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 036-042961 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036-042961-2 | 05 |
| Street Address |
9831 S WESTERN AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60643-1740 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598234999 | Colleen Marie Tumino | Registered Nurse | 9831 S Western Ave, Chicago, IL 60643-1740 | 2018-11-15 |
| 1144799446 | Robert Joseph Stachler | Massage Therapist | 9831 S Western Ave, Chicago, IL 60643-1740 | 2018-11-15 |
| 1164991568 | Karen Lynn Duggan | Registered Nurse | 9831 S Western Ave, Chicago, IL 60643-1740 | 2018-11-15 |
| 1881163285 | Megan Corr | Registered Nurse | 9831 S Western Ave, Chicago, IL 60643-1740 | 2018-11-15 |
| 1952895971 | Vaishali Shah | Pharmacist | 9831 S Western Ave, Chicago, IL 60643-1740 | 2018-06-22 |
| 1174045462 | Kinsey Nolan | Registered Nurse | 9831 S Western Ave, Chicago, IL 60643-1740 | 2017-07-09 |
| 1467981571 | Karmen Maytum | Nurse Practitioner | 9831 S Western Ave, Chicago, IL 60643-1740 | 2017-06-12 |
| 1386178226 | Kristy Hynes | Nurse Practitioner | 9831 S Western Ave, Chicago, IL 60643-1740 | 2017-04-18 |
| 1154878510 | Ewa Rafacz | Registered Nurse | 9831 S Western Ave, Chicago, IL 60643-1740 | 2016-09-02 |
| 1972959054 | Advocate Medical Group | Clinic/Center | 9831 S Western Ave, Suite 396, Chicago, IL 60643-1740 | 2016-05-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154941698 | Breann Hampton | Behavior Technician | 1214 W 115th St, Chicago, IL 60643 | 2020-04-24 |
| 1366075566 | Sanctuary Counseling, LLC | Home Health | 12247 S Racine Ave, Calumet Park, IL 60643 | 2020-02-16 |
| 1467082883 | Juliana Frances Cunningham | Developmental Therapist | 10037 S Bell, Chicago, IL 60643 | 2020-01-24 |
| 1013578624 | Sct Counseling | Counselor | 11948 S Western Ave, Chicago, IL 60643 | 2019-06-25 |
| 1073087474 | For Eyes Optical Company of Pa | Optometrist | 9900 S Ridgleland Ave, Chicago Ridge, IL 60643 | 2019-01-18 |
| 1073096426 | Derek Peake | Physical Therapist | 9465 S. Western Road, Chicago, IL 60643 | 2018-09-12 |
| 1508356072 | Halo Medical Professionals Sc. | Chiropractor | 10650 S Western Ave, Chicago, IL 60643 | 2018-05-10 |
| 1811405699 | Kara Eileen Noland | Developmental Therapist | 9327 S Hamilton Ave, Chicago, IL 60643 | 2018-01-16 |
| 1588173546 | Kiah Nicole Bouie | Behavioral Analyst | 1461 W 113th Pl, Chicago, IL 60643 | 2017-09-21 |
| 1174042766 | Travis Wade Robertson | Physical Therapist | 10909-11 S Western Ave, Beverly, IL 60643 | 2017-09-14 |
| Find all providers in zip 60643 | ||||
| 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 |
|---|---|---|---|---|
| 1114551983 | Katherine Janezic | Dermatology | 7447 W Talcott Ave Ste 425, Chicago, IL 60631-3704 | 2020-03-02 |
| 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 |
| 1275013450 | Advanced Dermatology and Aesthetic Medicine | Dermatology | 850 S Wabash Ave Ste 200, Chicago, IL 60605-3642 | 2018-08-17 |
| 1346784543 | Dermio, LLC | Dermatology | 3023 N Clark St, Suite 861, Chicago, IL 60657-5200 | 2016-12-07 |
| 1366823544 | Oyinade Aderibigbe | Dermatology | 111 W Washington St Ste 1801, Chicago, IL 60602-3430 | 2015-06-14 |
| 1073909032 | Julia Dai | Dermatology | 5758 S Maryland Ave Fl 3, Chicago, IL 60637 | 2015-04-07 |
| 1437544582 | Nicholas Blickenstaff | Dermatology | 30 N Michigan Ave Ste 1429, Chicago, IL 60602-3698 | 2015-04-04 |
| 1801285929 | Medical Dermatology Associates of Chicago, Ltd | Dermatology | 363 W Erie St, Suite 350, Chicago, IL 60654-6903 | 2015-01-13 |
| 1366857286 | Noor Tazudeen | Dermatology | 4700 N Marine Dr Ste 220, Chicago, IL 60640-7972 | 2014-06-30 |
| Find all providers in CHICAGO | ||||
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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.