CHARLES DOBBIN CONNOR (NPI# 1992763353) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992763353 |
| Entity Type | Individual |
| Full Name | CHARLES DOBBIN CONNOR |
| Credential | M.D. |
| Practice Address |
22 Professional Park Dr Maryville IL 62062-5669 |
| Practice Telephone | 6182880998 |
| Practice Fax Number | 6182889934 |
| Mailing Telephone | 6182880998 |
| Mailing Fax Number | 6182889934 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2007-12-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | IL | Allopathic & Osteopathic Physicians | |
| Y | 207NS0135X |
Dermatology Specialization: Procedural Dermatology |
IL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS/BLUE SHIELD | 06032047 | 01 |
| IL | HEALTHLINK | 294801 | 01 |
| IL | AETNA | 4233211 | 01 |
| IL | CIGNA | 2644579 | 01 |
| IL | CCN | 5226143 | 01 |
| IL | UNITEDHEATHCARE | 0300073 | 01 |
| IL | MERCY | G37507 | 01 |
| IL | FIRST HEALTH | 1736541 | 01 |
| IL | GHP | 127279 | 01 |
| IL | AETNA MANAGED CARE | 2119084 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538191960 | Charles William Connor Jr. | Dentist | 1146 N New Hope Rd, Gastonia, NC 28054-2959 | 2006-07-07 |
| 1558354696 | Charles G Connor | Optometrist | 9725 Datapoint Dr, San Antonio, TX 78229-2384 | 2005-08-24 |
| 1851447320 | Charles P. Connor | Psychiatry & Neurology | 3569 Sacramento St, San Francisco, CA 94118-1866 | 2007-01-26 |
| 1538102934 | Charles Keith Connor | Internal Medicine | 3705 W 15th St, Plano, TX 75075-7753 | 2006-06-14 |
| Street Address |
22 PROFESSIONAL PARK DR |
| City | MARYVILLE |
| State | IL |
| Zip Code | 62062-5669 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619271939 | Dermatology Care Center, Ltd. | Dermatology | 22 Professional Park Dr, Maryville, IL 62062-5669 | 2010-12-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104325091 | Jennifer M Oyler | Physician Assistant | 6812 State Route 162 Suite 120, Maryville, IL 62062 | 2018-02-06 |
| 1710495965 | Sarah Elizabeth Barto | Family Medicine | 2133 Vadalabene Drive, Suite Sb, Maryville, IL 62062 | 2018-01-22 |
| 1104348085 | Lindsey Nicole Langendorf | Chiropractor | 62 Executive Plaza Ct, Maryville, IL 62062 | 2017-07-12 |
| 1043750540 | Gina Saal | Nurse Anesthetist, Certified Registered | 6800 Rt 162, Maryville, IL 62062 | 2017-03-02 |
| 1548657737 | Karen Michelle Bertels | Emergency Medicine | 6800 Il - 162, Maryville, IL 62062 | 2015-04-25 |
| 1811258148 | Debra Ann Hoelscher | Internal Medicine | 2102 Vadalabene, Maryville, IL 62062 | 2012-06-04 |
| 1538438445 | Casey Elizabeth Wiesemeyer | Speech-Language Pathologist | 2201 Copper Creek Rd, Maryville, IL 62062 | 2011-12-21 |
| 1407144819 | Norah Claire Farley Baker | Family Medicine | 10 Professional Park Dr., Maryville, IL 62062 | 2011-07-19 |
| 1891092474 | Kimberly M Schneider | Physician Assistant | 20b Professional Park Drive, Maryville, IL 62062 | 2011-02-17 |
| 1669782397 | Purandhri Patel | Physical Therapist | 6820 State Route 162, Maryville, IL 62062 | 2010-10-15 |
| Find all providers in zip 62062 | ||||
| Taxonomy Code | 207NS0135X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Procedural Dermatology |
| Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surgery, cryosurgery (liquid nitrogen), electrosurgery, aspiration surgery, liposuction, injection of filler substances, and Mohs micrographic controlled surgery (a special technique for the removal of growths, especially skin cancers). |
| Notes: Source: American Board of Dermatology, 2007, www.abderm.org [1/1/2008: definition added, source added, title changed] Additional Resources: Some ABMS board certified dermatologists have completed a one-year ACGME approved fellowship in Procedural Dermatology, which has been offered since 2003. At this time the ABD does not offer subspecialty certification in Procedural Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538313705 | Valeria Fugali | Dermatology | 1807 N Mohawk St, Unit B, Chicago, IL 60614-5213 | 2008-11-13 |
| 1922212539 | Neda Ashourian | Dermatology | 676 N. St. Clair Street, Suite 1600, Chicago, IL 60611-2997 | 2007-05-10 |
| 1972669109 | Raymond W Vahl | Dermatology | 11527 S Harlem Ave, Worth, IL 60482-2367 | 2006-12-30 |
| 1013983618 | David H Whitney | Dermatology | 3253 S Harlem Ave, Suite 1a, Berwyn, IL 60402-3073 | 2006-02-24 |
| 1205825056 | Amy L Brodsky | Dermatology | 2601 Compass Rd Ste 125, Glenview, IL 60026-8089 | 2005-10-14 |
| 1427589027 | Forefront Dermatology, S.c. | Dermatology | 1170 E Belvidere Rd, Suite 206, Grayslake, IL 60030 | 2017-03-24 |
| 1235685256 | Forefront Dermatology, S.c. | Dermatology | 2800 N Sheridan Rd, Suite 508, Chicago, IL 60657 | 2016-08-30 |
| 1750837761 | Forefront Dermatology, S.c. | Dermatology | 550 E Boughton Rd, Suite 170, Bolingbrook, IL 60440 | 2016-08-30 |
| 1871046995 | Forefront Dermatology, S.c. | Dermatology | 615 Valley View Dr, Suite 203, Moline, IL 61265 | 2016-07-25 |
| 1528430881 | Forefront Dermatology, S.c. | Dermatology | 507 W Kendall Dr, Suite 2, Yorkville, IL 60560 | 2015-10-27 |
| 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.