Nicholas Ray Blickenstaff (NPI# 1437544582, PAC ID# 2466748397) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1437544582 |
| PAC ID by PECOS | 2466748397 |
| Professional Enrollment ID | I20190711000119 |
| Full Name | Nicholas Ray Blickenstaff |
| Organization Legal Name | PINNACLE DERMATOLOGY SC |
| Address |
7123 W Archer Ave Chicago IL 60638-2203 |
| Phone Number | 8157448554 |
| Gender | M |
| Medical School | UNIVERSITY OF UTAH SCHOOL OF MEDICINE |
| Graduation Year | 2015 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 8628353380 |
| Number of Group Practice Members | 58 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 595 William Latham Dr, Bourbonnais, IL 60914-2319 | 8157448554 | PINNACLE DERMATOLOGY SC |
| 7123 W Archer Ave, Chicago, IL 60638-2203 | 8157448554 | PINNACLE DERMATOLOGY SC |
| Organization Legal Name | PINNACLE DERMATOLOGY SC |
| Physicians | 52 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Vincent Ross Smith | Nurse Practitioner | Pinnacle Dermatology Sc | 3501 Enterprise Ave, Valparaiso, IN 46383-6953 |
| Emily Michelle Beck | Dermatology | Pinnacle Dermatology Sc | 20646 Abbey Woods Ct N, Suite 104, Frankfort, IL 60423-3170 |
| Marianne Azneer | Physician Assistant | Pinnacle Dermatology Sc | 37605 Pembroke Ave, Livonia, MI 48152-1050 |
| Blake M Troiani | Dermatology | Pinnacle Dermatology Sc | 1124 Essington Rd, Suite A, Joliet, IL 60435-8423 |
| Bishr Ahmad Al Dabagh | Dermatology | Pinnacle Dermatology Sc | 5084 Villa Linde Pkwy, Suite 5, Flint, MI 48532-3422 |
| Ishani P Patel | Physician Assistant | Pinnacle Dermatology Sc | 2500 S Highland Ave, Suite 320, Lombard, IL 60148-5390 |
| Tehming Liang | Dermatology | Pinnacle Dermatology Sc | 580 E Boughton Rd, Suite A, Bolingbrook, IL 60440-2565 |
| Loris A Tisocco | Dermatology | Pinnacle Dermatology Sc | 275 Joliet St, Suite 225, Dyer, IN 46311-1789 |
| Michael Jude Welsch | Dermatology | Pinnacle Dermatology Sc | 1828 Bay Scott Cir, Naperville, IL 60540-1110 |
| David P Van Dam | Dermatology | Pinnacle Dermatology Sc | 738 W Northwest Hwy, Barrington, IL 60010-2640 |
| Street Address |
7123 W ARCHER AVE |
| City | CHICAGO |
| State | IL |
| Zip | 60638-2203 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Shirley Jean Baptiste | Dermatology | Pinnacle Dermatology Sc | 7123 W Archer Ave, Chicago, IL 60638-2203 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Joseph P Laluya | Physical Medicine and Rehabilitation | American Current Care of Illinois PC | 5015 W 6th St, Bedford Park, IL 60638 |
| Michael Awad | Obstetrics/gynecology | Magdy K Awad Md Sc | 5311 S Harlem Ave, Chicago, IL 60638-1006 |
| Magdy K Awad | Obstetrics/gynecology | Magdy K Awad Md Sc | 5311 S Harlem Ave, Chicago, IL 60638-1006 |
| Lawrence A Woss | Chiropractic | 5839 S Archer Ave, Chicago, IL 60638-1619 | |
| Nicole Olaya | Physical Therapy | Chicago Rehabilitation Services Inc | 5764 S Archer Ave, Chicago, IL 60638-1643 |
| John R Bylewski | Internal Medicine | 5780 S Archer Ave, Chicago, IL 60638-1644 | |
| Bernard L Slusinski | Family Medicine | 5680 S Archer Ave, Suite 100, Chicago, IL 60638-1677 | |
| Amy Guan | Nurse Practitioner | Access Community Health Network | 4839 W 47th St, Chicago, IL 60638-2039 |
| Carol P Wardlaw | Nurse Practitioner | Access Community Health Network | 4839 W 47th St, Southwest Family Health Center, Chicago, IL 60638-2039 |
| Loritz M Chavez | Hospitalist | 4940 S Cicero Ave, Chicago, IL 60638-2116 | |
| Find all physicians in zip 60638 | |||
| City | CHICAGO |
| Zip Code | 60638 |
| Specialty | DERMATOLOGY |
| City + Specialty | CHICAGO + DERMATOLOGY |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.