KELLE BERGGREN (NPI# 1730167198) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730167198 |
| Entity Type | Individual |
| Full Name | KELLE BERGGREN |
| Credential | MD |
| Practice Address |
199 Town Square Ste A Wheaton IL 60187 |
| Mailing Address |
1860 Paysphere Cir Chicago IL 60674-0018 |
| Practice Telephone | 6308716690 |
| Mailing Telephone | 6304699200 |
| Enumeration Date | 2006-01-05 |
| Last Update Date | 2018-08-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 036108970 | IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | 036108970 | 05 | |
| IL | RR MEDICARE | P00100007 | 01 |
| Street Address |
199 TOWN SQUARE STE A |
| City | WHEATON |
| State | IL |
| Zip Code | 60187 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750507133 | Edward Patrick Conrad | Dermatology | 199 Town Square, Ste A, Wheaton, IL 60187 | 2007-04-17 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811510738 | Arielle Susan Kalvelage | Counselor | Central Public Health Center (cphc), 111 N. County Farm Road, Wheaton, IL 60187 | 2020-05-27 |
| 1801418363 | Peter Gerard Harvey | Acupuncturist | 200 East Willow Avenue, Suite 202, Wheaton, IL 60187 | 2020-05-07 |
| 1760028823 | Teresa Clasen | Counselor | 222 Willow Ave, Wheaton, IL 60187 | 2019-11-25 |
| 1821630757 | Eastern Healing Inc. | Acupuncturist | 200 E. Willow Ave., Suite 202, Wheaton, IL 60187 | 2019-10-11 |
| 1952816282 | Caprishea Jones | Counselor | 111 N County Farm Road, Wheaton, IL 60187 | 2017-12-08 |
| 1265880330 | Bryan Cairncross | Specialist/Technologist | 1503 Beecher Ave., Wheaton, IL 60187 | 2016-05-31 |
| 1811357544 | Patricia Diaz | Nurse Practitioner | 0n620 West Street, Wheaton, IL 60187 | 2016-02-23 |
| 1962819227 | Breakthrough Care Center | Clinic/Center | 150 E. Willow Ave, Ste 100, Wheaton, IL 60187 | 2014-07-18 |
| 1780005587 | Kyler Mulhauser | Counselor | 600 W. Roosevelt Rd, Suite A2, Wheaton, IL 60187 | 2013-12-20 |
| 1538593074 | Deborah Bates | Psychologist | 300 E Roosevelt Rd Ste 105, Wheaton, IL 60187 | 2013-08-31 |
| Find all providers in zip 60187 | ||||
| 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 |
|---|---|---|---|---|
| 1750507133 | Edward Patrick Conrad | Dermatology | 199 Town Square, Ste A, Wheaton, IL 60187 | 2007-04-17 |
| 1023133071 | Plastic Surgery Consultants Ltd | Dermatology | 199 Town Sq, Suite E, Wheaton, IL 60189-3878 | 2007-03-20 |
| 1407822216 | James Herrmann | Dermatology | 199 Town Sq, Ste A, Wheaton, IL 60187-3878 | 2006-02-23 |
| 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.