DR. NICOLE ANN HARTSOUGH (NPI# 1962400382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962400382 |
| Entity Type | Individual |
| Full Name | DR. NICOLE ANN HARTSOUGH |
| Credential | M.D. |
| Practice Address |
7402 E Riverside Blvd Loves Park IL 61111-5630 |
| Practice Telephone | 8152269642 |
| Practice Fax Number | 8152269672 |
| Mailing Telephone | 8152269642 |
| Mailing Fax Number | 8152269672 |
| Enumeration Date | 2005-07-10 |
| Last Update Date | 2007-10-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | IL | Allopathic & Osteopathic Physicians |
| Street Address |
7402 E RIVERSIDE BLVD |
| City | LOVES PARK |
| State | IL |
| Zip Code | 61111-5630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992907893 | Aashish Taneja | Dermatology | 7402 E Riverside Blvd, Loves Park, IL 61111-5630 | 2007-06-03 |
| 1326028143 | Kevin M. Burns | Physician Assistant | 7402 E Riverside Blvd, Loves Park, IL 61111-5630 | 2006-01-18 |
| 1881695468 | Nahd Sc | Specialist | 7402 E Riverside Blvd, Loves Park, IL 61111-5630 | 2005-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316562788 | Salli Jacobsen | Technician | 6699 Torch Lite Tr, Loves Park, IL 61111 | 2020-06-11 |
| 1003476425 | Costco Wholesale Corporation | Pharmacy | 5000 Stadium Drive, Loves Park, IL 61111 | 2019-06-18 |
| 1427541077 | Ronit Golan | Physical Therapist | 4401 Peak Dr Ste 1, Loves Park, IL 61111 | 2018-06-08 |
| 1598049025 | Sara Debelak | Developmental Therapist | 7225 Golden Eagle Drive, Loves Park, IL 61111 | 2011-10-03 |
| 1083906382 | Gagandeep Goyal | Anesthesiology | 5504 N 2nd St, Loves Park, IL 61111 | 2011-05-05 |
| 1124354261 | Asap Transport, LLC | Taxi | 7117 Clinton Rd, Suite 4, Loves Park, IL 61111 | 2009-10-25 |
| 1235212275 | Roger H Hill | Optometrist | 4301 N Mulford Rd, Loves Park, IL 61111 | 2006-10-23 |
| 1831104546 | Pointcore, Inc. | Pharmacy | 9951 Rock Cut Crossing, Loves Park, IL 61111 | 2006-07-30 |
| 1629099627 | Lisa A. Breisch | Counselor | Harmony Center for Holistic Psychotherapy, 6625 N. 2nd Street, Loves Park, IL 61111 | 2006-07-22 |
| 1386670529 | Joseph L Digirolamo | Chiropractor | 116 East Riverside Blvd, Loves Park, IL 61111 | 2006-06-22 |
| Find all providers in zip 61111 | ||||
| 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 |
|---|---|---|---|---|
| 1992907893 | Aashish Taneja | Dermatology | 7402 E Riverside Blvd, Loves Park, IL 61111-5630 | 2007-06-03 |
| 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 | ||||
| City | LOVES PARK |
| Zip Code | 61111 |
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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.