ASSOCIATES IN DERMATOLOGY SC (NPI# 1689863904) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689863904 |
| Entity Type | Organization |
| Organization Name | ASSOCIATES IN DERMATOLOGY SC |
| Practice Address |
1404 Eastland Drive Suite 204 Bloomington IL 61701-3532 |
| Practice Telephone | 3096628813 |
| Practice Fax Number | 3096626835 |
| Mailing Telephone | 3096628813 |
| Mailing Fax Number | 3096626835 |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2008-04-20 |
| Authorized Official Name | MRS. LORA F PHELPS (INSURANCE BILLING ACCOUNTS PAYABLE) |
| Authorized Official Telephone | 3096628813 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Street Address |
1404 EASTLAND DRIVE SUITE 204 |
| City | BLOOMINGTON |
| State | IL |
| Zip Code | 61701-3532 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447355383 | Surgical Associates of Bloomington, Ill,ltd | Surgery | 1404 Eastland Drive, Suite 104, Bloomington, IL 61701 | 2006-09-14 |
| 1609134865 | Eastland Dental Center, Ltd. | Clinic/Center | 1404 Eastland Drive, Ste 101, Bloomington, IL 61701 | 2012-04-25 |
| 1598803330 | Thomas Richard Brander | Dermatology | 1404 Eastland Drive, Suite 204, Bloomington, IL 61701 | 2007-02-02 |
| 1619015450 | James Richard Seehafer | Dermatology | 1404 Eastland Drive, Suite 204, Bloomington, IL 61701 | 2007-02-02 |
| 1669510400 | Lucy Nelson Wisdom | Dermatology | 1404 Eastland Drive, Suite 204, Bloomington, IL 61701 | 2007-02-02 |
| 1326136656 | Deborah S Pitcher | Audiologist | 1404 Eastland Drive, Suite 203, Bloomington, IL 61701 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770140964 | County of Mclean | Community/Behavioral Health | 200 W Front St, 1st Floor Sw, C/o 200 W Front St, Suite 400f, Bloomington, IL 61701 | 2019-05-22 |
| 1023525292 | Karli Johnson | Counselor | 200 W Monroe St Ste C7, Bloomington, IL 61701 | 2018-01-09 |
| 1487172409 | Melody Ann Bauman | Physician Assistant | 1505 Eastland Dr, Osf Critical Cane, Pulmonary, Sleep M, Bloomington, IL 61701 | 2017-08-30 |
| 1215396288 | Heidi Larsen | Social Worker | 902 S East St, Bloomington, IL 61701 | 2016-02-18 |
| 1558735126 | Andrea E. Andrews Counseling LLC | Counselor | 200 W. Monroe St., Ste 302 C, Bloomington, IL 61701 | 2015-11-19 |
| 1174924856 | Carole Hahn | Dietitian, Registered | 1406 Forrest St, Bloomington, IL 61701 | 2014-09-12 |
| 1558786392 | Valerie Colleen Parker | Counselor | 109 W. Mulberry St., Bloomington, IL 61701 | 2014-03-04 |
| 1124459219 | Matilde Francois | Surgery | 1505 Eastland Dr Ste 2300, Bloomington, IL 61701 | 2013-11-27 |
| 1922435114 | Smitha H Shivaprasad | Pharmacist | 2611 East Oakland Avenue, Bloomington, IL 61701 | 2013-10-02 |
| 1295161941 | Ashvin Patel | Obstetrics & Gynecology | 31 Country Club Pl, Bloomington, IL 61701 | 2013-09-25 |
| Find all providers in zip 61701 | ||||
| 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 |
|---|---|---|---|---|
| 1740415777 | Adrienne Schupbach | Dermatology | 3024 E Empire St Ste E&f, Bloomington, IL 61704-5402 | 2009-05-19 |
| 1003914920 | Bloomington Dermatology Clinic | Dermatology | 2001 E 3rd St, Bloomington, IN 47401-7890 | 2006-09-21 |
| 1528008414 | Rajagopala Swaminathan | Dermatology | 3024 E Empire St Ste Eandf, Bloomington, IL 61704-5402 | 2006-06-08 |
| 1366442444 | Kent S. Taulbee | Dermatology | 2418 E Lincoln St, Bloomington, IL 61701-5915 | 2005-07-29 |
| 1578567343 | Mary Kathleen Mctigue | Dermatology | 1200 S Rogers St, Bloomington, IN 47403-4792 | 2005-06-09 |
| 1184000531 | Roxanne Rajaii | Dermatology | 1200 S Rogers St, Bloomington, IN 47403-4792 | 2015-08-08 |
| 1669867669 | Michelle Gita Baechtold | Dermatology | 1200 S Rogers St, Bloomington, IN 47403-4792 | 2015-04-06 |
| 1144489618 | Elizabeth Kim Farhat | Dermatology | 7920 Old Cedar Ave S, Bloomington, MN 55425-1207 | 2008-06-09 |
| 1801063128 | Carrie Lynn Davis | Dermatology | 1200 S Rogers St, Bloomington, IN 47403-4792 | 2008-05-15 |
| 1689846909 | Talley Bhanyang Whang | Dermatology | 1200 S Rogers St, Bloomington, IN 47403-4792 | 2008-03-26 |
| Find all providers in BLOOMINGTON | ||||
| City | BLOOMINGTON |
| Zip Code | 61701 |
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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.