Wynn Kao (NPI# 1790996890, PAC ID# 8820277544) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is DERMATOLOGY.
| Nation Provider ID (NPI) | 1790996890 |
| PAC ID by PECOS | 8820277544 |
| Professional Enrollment ID | I20170707000967 |
| Full Name | Wynn Kao |
| Organization Legal Name | DERMATOLOGY AND MOHS SURGERY INSTITUTE LTD |
| Address |
3024 E Empire St 2nd Floor E and F Bloomington IL 61704-5402 |
| Phone Number | 3094513376 |
| Gender | M |
| Medical School | HARVARD MEDICAL SCHOOL |
| Graduation Year | 2004 |
| Primary Specialty | DERMATOLOGY |
| Group Practice PAC ID | 3870732191 |
| Number of Group Practice Members | 9 |
| Accepts Medicare Assignment | Y |
| Address | Phone | Organization |
|---|---|---|
| 3024 E Empire St 2nd Floor E and F, Bloomington, IL 61704-5402 | 3094513376 | DERMATOLOGY AND MOHS SURGERY INSTITUTE LTD |
| Organization Legal Name | DERMATOLOGY AND MOHS SURGERY INSTITUTE LTD |
| Physicians | 9 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher S Lillie | Physician Assistant | Dermatology and Mohs Surgery Institute Ltd | 3024 E Empire St 2nd Floor E and F, Bloomington, IL 61704-5402 |
| Rajagopala Swaminathan | Dermatology | Dermatology and Mohs Surgery Institute Ltd | 812 W Trailcreek Dr, Peoria, IL 61614-1862 |
| Douglas M Leone | Dermatology | Dermatology and Mohs Surgery Institute Ltd | 925 W St, Suite 212, Peru, IL 61354-2769 |
| Kent S Taulbee | Dermatology | Dermatology and Mohs Surgery Institute Ltd | 3024 E Empire St 2nd Floor E and F, Bloomington, IL 61704-5402 |
| Jeffrey K Mckenna | Dermatology | Dermatology and Mohs Surgery Institute Ltd | 3024 E Empire St 2nd Floor E and F, Bloomington, IL 61704-5402 |
| Jennifer Lynn Stern | Nurse Practitioner | Dermatology and Mohs Surgery Institute Ltd | 3024 E Empire St 2nd Floor E and F, Bloomington, IL 61704-5402 |
| Adrienne M Schupbach | Dermatology | Dermatology and Mohs Surgery Institute Ltd | 925 W St, Suite 212, Peru, IL 61354-2769 |
| Stephanie A Pasley | Nurse Practitioner | Dermatology and Mohs Surgery Institute Ltd | 3024 E Empire St 2nd Floor E and F, Bloomington, IL 61704-5402 |
| Street Address |
3024 E EMPIRE ST 2ND FLOOR E AND F |
| City | BLOOMINGTON |
| State | IL |
| Zip | 61704-5402 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Christopher S Lillie | Physician Assistant | Dermatology and Mohs Surgery Institute Ltd | 3024 E Empire St 2nd Floor E and F, Bloomington, IL 61704-5402 |
| Kent S Taulbee | Dermatology | Dermatology and Mohs Surgery Institute Ltd | 3024 E Empire St 2nd Floor E and F, Bloomington, IL 61704-5402 |
| Jeffrey K Mckenna | Dermatology | Dermatology and Mohs Surgery Institute Ltd | 3024 E Empire St 2nd Floor E and F, Bloomington, IL 61704-5402 |
| Jennifer Lynn Stern | Nurse Practitioner | Dermatology and Mohs Surgery Institute Ltd | 3024 E Empire St 2nd Floor E and F, Bloomington, IL 61704-5402 |
| Stephanie A Pasley | Nurse Practitioner | Dermatology and Mohs Surgery Institute Ltd | 3024 E Empire St 2nd Floor E and F, Bloomington, IL 61704-5402 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Leah C Swanson | Clinical Social Worker | Elliott Counseling Services LLC | 209 S Prospect, Suite 1, Bloomington, IL 61704 |
| Cheri Miller | Psychologist, Clinical | Advocate Health and Hospitals Corporation | 303 N Hershey, Suite 2c, Bloomington, IL 61704 |
| Dennis M Brtva | Optometry | Central Illinois Family Eyecare LLC | 2109 N Veterans Pkwy, Suite 2, Bloomington, IL 61704-0910 |
| Christopher James Wetzler | Optometry | Central Illinois Family Eyecare LLC | 2109 N Veterans Pkwy, Suite 2, Bloomington, IL 61704-0910 |
| Ashley Elizabeth Foster | Optometry | Central Illinois Family Eyecare LLC | 2109 N Veterans Pkwy, Suite 2, Bloomington, IL 61704-0910 |
| Preston Langdon Smith | Optometry | Central Illinois Family Eyecare LLC | 2109 N Veterans Pkwy, Suite 2, Bloomington, IL 61704-0910 |
| Kristine C Winkler | Nurse Practitioner | Encounter Telehealth LLC | 11 Harbor Pointe Ct, Bloomington, IL 61704-1409 |
| Robert J Hermann | Chiropractic | 2415 E Washington St F, Bloomington, IL 61704-1609 | |
| Robert D Brown | Chiropractic | 2422 E Washington St, Suite 202, Bloomington, IL 61704-1611 | |
| Julie R Dostal | Registered Dietitian Or Nutrition Professional | 2412 E Washington St, Suite 1b, Bloomington, IL 61704-1613 | |
| Find all physicians in zip 61704 | |||
| City | BLOOMINGTON |
| Zip Code | 61704 |
| Specialty | DERMATOLOGY |
| City + Specialty | BLOOMINGTON + 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.