FOREFRONT DERMATOLOGY, S.C. (NPI# 1760854020) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760854020 |
| Entity Type | Organization |
| Organization Name | FOREFRONT DERMATOLOGY, S.C. |
| Practice Address |
1 Erie Ct Suite 4010 Oak Park IL 60302 |
| Mailing Address |
801 York St Manitowoc WI 54220-4630 |
| Practice Telephone | 7084240656 |
| Practice Fax Number | 6309040413 |
| Mailing Telephone | 9206639016 |
| Mailing Fax Number | 9206841439 |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2018-05-17 |
| Authorized Official Name | DR. BETSY J WERNLI (PRESIDENT) |
| Authorized Official Telephone | 9204820671 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154815546 | Forefront Dermatology, S.c. | Dermatology | 7720 Us Highway 98 W Ste 240, Miramar Beach, FL 32550-7232 | 2018-06-19 |
| 1518480136 | Forefront Dermatology, S.c. | Dermatology | 8134 Old Georgetown Rd, Bethesda, MD 20814 | 2017-07-25 |
| 1578097572 | Forefront Dermatology, S.c. | Dermatology | 4020 New Vision Drive, Fort Wayne, IN 46845 | 2017-04-17 |
| 1851822548 | Forefront Dermatology, S.c. | Dermatology | 1600 S Beacon Blvd, Suite 160, Grand Haven, MI 49417 | 2017-03-23 |
| 1245777994 | Forefront Dermatology, S.c. | Dermatology | 11137 U.S. 52, Brookville, IN 47012 | 2017-01-19 |
| 1982140265 | Forefront Dermatology, S.c. | Dermatology | 8567 Watson Rd, Webster Groves, MO 63119 | 2017-01-11 |
| 1386194371 | Forefront Dermatology, S.c. | Dermatology | 7200 Washington Ave, Suite 100, Mount Pleasant, WI 53406 | 2016-10-13 |
| 1356891402 | Forefront Dermatology, S.c. | Dermatology | 1515 S Green Bay Rd, Racine, WI 53406 | 2016-10-12 |
| 1619424744 | Forefront Dermatology, S.c. | Dermatology | 5700 Mexico Rd, Suite 14, Saint Peters, MO 63376 | 2016-09-07 |
| 1629524913 | Forefront Dermatology, S.c. | Dermatology | 159 S. English Station Road, Louisville, KY 40245 | 2016-08-28 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Iowa Business Entities | FOREFRONT DERMATOLOGY, S.C., | 801 York St, Manitowoc, WI 54220 |
| Street Address |
1 ERIE CT SUITE 4010 |
| City | OAK PARK |
| State | IL |
| Zip Code | 60302 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508861691 | Nagulapalli S Rao | Specialist | 1 Erie Ct, Ste 7160, Oak Park, IL 60302-2510 | 2005-06-16 |
| 1528531837 | Pipeline Midwest Pharmacies, LLC | Pharmacy | 1 Erie Ct, Oak Park, IL 60302-2566 | 2019-01-09 |
| 1326577057 | Joanna Marie Curran | Family Medicine | 1 Erie Ct, Oak Park, IL 60302-2566 | 2017-06-06 |
| 1033660303 | Megan L Mccaleb | Physician Assistant | 1 Erie Ct, Suire 7120, Oak Park, IL 60302-2566 | 2016-10-20 |
| 1760936090 | Genti Manco | Nurse Practitioner | 1 Erie Ct, Oak Park, IL 60302-2566 | 2016-08-03 |
| 1699137869 | Morgan Crandall | Physician Assistant | 1 Erie Ct, Suite 7120, Oak Park, IL 60302-2566 | 2016-03-25 |
| 1154700557 | Haley Combs | Student in an Organized Health Care Education/Training Program | 1 Erie Ct, Suite 6160, Oak Park, IL 60302-2566 | 2015-05-19 |
| 1023497344 | Jacob Shaw | Family Medicine | 1 Erie Ct, Oak Park, IL 60302 | 2015-05-19 |
| 1225428774 | Ashleigh Jardine | Physical Therapist | 1 Erie Ct, Suite 7120, Oak Park, IL 60302-2566 | 2015-02-04 |
| 1023352283 | Elizabeth J Racioppi | Physical Therapist | 1 Erie Ct, Suite 7140, Oak Park, IL 60302-2566 | 2012-11-12 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306473244 | Tasha Kimberly Young | Counselor | 1216 N Austin Bvld, Oak Park, IL 60302 | 2020-03-23 |
| 1306492186 | Camiesa Rashida Rogers | Pharmacy Technician | 626 N Austin #7, Oak Park, IL 60302 | 2019-08-16 |
| 1326603887 | Right Choice Therapy LLC | Social Worker | 428 S. Scoville Avenue, Rear 1b, Oak Park, IL 60302 | 2019-05-09 |
| 1407328941 | Arundathi Bannur Suresh | Occupational Therapist | 3 Erie Court, West Suburban Medical Center, Oak Park, IL 60302 | 2018-12-21 |
| 1427537455 | Shannon Vogel | Occupational Therapist | 405 Home Ave Apt 207, Oak Park, IL 60302 | 2018-08-10 |
| 1568958726 | Loretto Hospital | Clinic/Center | 1000 Madison St, Oak Park, IL 60302 | 2018-07-10 |
| 1649783143 | Mary Joyce Arenas Lagatao | Nurse Practitioner | 101 Madison St, 3rd Floor, Oak Park, IL 60302 | 2017-11-07 |
| 1427578251 | Amanda Lam | Behavior Technician | 721 South Blvd., Suite 210, Oak Park, IL 60302 | 2017-06-22 |
| 1649790577 | Samantha Lotti | Acupuncturist | 1119 Pleasant St, Oak Park, IL 60302 | 2017-06-21 |
| 1770010480 | Robert Smith IIi | Behavior Technician | 412a S. Taylor Ave, Oak Park, IL 60302 | 2017-05-12 |
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| 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 |
|---|---|---|---|---|
| 1124675244 | Kiracofe Md Medical, LLC | Dermatology | 719 South Blvd # 2903, Oak Park, IL 60302-2903 | 2019-08-22 |
| 1336400217 | Elizabeth Anne Kiracofe | Dermatology | 719 South Blvd, Oak Park, IL 60302-2903 | 2012-06-06 |
| 1538297874 | Santi Rukvidtayasas | Dermatology | 7047 North Ave, Oak Park, IL 60302-1015 | 2007-02-28 |
| 1609876697 | Bryan Christopher Schultz | Dermatology | 1050 Chicago Ave, Oak Park, IL 60302-1835 | 2005-07-30 |
| 1497972418 | Academic & Clinical Associates In Dermatology Ltd | Dermatology | 7047 North Ave, Oak Park, IL 60302-1015 | 2007-04-19 |
| 1508994591 | Richard Bernstein | Dermatology | 7047 North Ave, Oak Park, IL 60302-1015 | 2007-03-01 |
| 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 |
| 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 |
| 1093270324 | Ashira Dermatology LLC of Ashira Industries LLC | Dermatology | 135 N Greenleaf St Ste 204&209, Gurnee, IL 60031-3393 | 2019-01-31 |
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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.