JORDAN C. CARQUEVILLE, MD LLC (NPI# 1710531330) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710531330 |
| Entity Type | Organization |
| Organization Name | JORDAN C. CARQUEVILLE, MD LLC |
| Practice Address |
125 W 2nd St Hinsdale IL 60521-4014 |
| Mailing Address |
2045 W Grand Ave Ste B Chicago IL 60612-1577 |
| Practice Telephone | 3123191978 |
| Enumeration Date | 2019-07-31 |
| Last Update Date | 2019-08-01 |
| Authorized Official Name | JORDAN CLAIRE CARQUEVILLE (PHYSICIAN) |
| Authorized Official Telephone | 6306386380 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 680 N Lake Shore Dr # 1425, Chicago, IL 606114546 | 3123191978 |
| Street Address |
125 W 2ND ST |
| City | HINSDALE |
| State | IL |
| Zip Code | 60521-4014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588616288 | Christina Gutierrez | Dermatology | 125 W 2nd St, Hinsdale, IL 60521-4014 | 2006-05-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386256170 | Infinity Yoga LLC | Counselor | 702 Mills St, Hinsdale, IL 60521 | 2020-08-21 |
| 1427696855 | Anne Didier | Nurse Practitioner | 40 South Clay St., Suite 200, West Building, Hinsdale, IL 60521 | 2019-12-16 |
| 1619469244 | Rush Oak Brook Surgery Center, LLC | Clinic/Center | 2011 York Road, Suite 3000, Oak Brook, IL 60521 | 2018-05-30 |
| 1639680275 | Kelly M Lyell | Psychologist | 950 S Oak St, Hinsdale, IL 60521 | 2017-10-23 |
| 1386169720 | Elizabeth Ann Thorsness | Counselor | 412 East Fourth St., Hinsdale, IL 60521 | 2017-08-07 |
| 1275057424 | Bryndal Nicole Chervinko | Audiologist | 908 North Elm Street, Suite 306, Hinsdale, IL 60521 | 2017-07-31 |
| 1972038990 | Carolyn M Ball | Counselor | 19 N Grant St Ste 2c, Hinsdale, IL 60521 | 2017-04-27 |
| 1710429964 | Smiling Star Speech & Language | Speech-Language Pathologist | 120 E Odgen Avenue, Suite 110, Hinsdale, IL 60521 | 2016-11-04 |
| 1972964773 | Sharon Grob Murphy | Psychologist | 728 S. Park Ave., Hinsdale, IL 60521 | 2016-03-08 |
| 1992187074 | Matthew Destefani | Emergency Medicine | 109 Symonds Dr # 578, Hinsdale, IL 60521 | 2015-06-24 |
| Find all providers in zip 60521 | ||||
| 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 |
|---|---|---|---|---|
| 1316142045 | Louisa K Gehlmann | Dermatology | 901 N Elm St., Hinsdale, IL 60521-1806 | 2007-06-21 |
| 1952319303 | Stephanie Freels | Dermatology | 908 N Elm St Ste 300, Hinsdale, IL 60521-3625 | 2006-08-03 |
| 1588616288 | Christina Gutierrez | Dermatology | 125 W 2nd St, Hinsdale, IL 60521-4014 | 2006-05-17 |
| 1902891377 | Alix J Charles | Dermatology | 40 S Clay St Ste Ll30, Hinsdale, IL 60521-3257 | 2005-09-13 |
| 1811144868 | Dolar R Koya Md Sc | Dermatology | 40 S Clay St, Suite 113d, Hinsdale, IL 60521-3257 | 2008-08-21 |
| 1679695829 | Dermatology Associates of Hinsdale, S.c. | Dermatology | 333 Chestnut St, Suite 202, Hinsdale, IL 60521-3247 | 2007-04-06 |
| 1669565222 | Erica Jean Rogers | Dermatology | 908 N Elm St Ste 300, Hinsdale, IL 60521-3625 | 2006-10-02 |
| 1023067964 | Aesthetic and Clinical Dermatology Associates, Ltd | Dermatology | 908 N Elm St, Suite 309, Hinsdale, IL 60521-3635 | 2006-05-08 |
| 1114975158 | Gina M Dillig | Dermatology | 908 N Elm St, Hinsdale, IL 60521-3635 | 2006-05-04 |
| 1497703458 | Matthew Nathan Harris | Dermatology | 333 Chestnut St, Hinsdale, IL 60521-3247 | 2006-05-04 |
| Find all providers in HINSDALE | ||||
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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.