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LOOP DERMATOLOGY & ACNE CARE CENTER LLC NPI 1104093483


NPI Information

NPI: 1104093483
Provider Name: LOOP DERMATOLOGY & ACNE CARE CENTER LLC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
111 N WABASH AVE
SUITE 2001
CHICAGO, IL
ZIP 60602
Phone: (312) 519-1465
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LOOP DERMATOLOGY & ACNE CARE CENTER LLC is a clinic center in Chicago, IL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). LOOP DERMATOLOGY & ACNE CARE CENTER LLC NPI is 1104093483. The provider is registered as an organization entity type.

The provider's business location address is:

111 N WABASH AVE
SUITE 2001
CHICAGO, IL
ZIP 60602-903
Phone: (312) 519-1465

The provider's authorized official is Michele Burgess .
The authorized official title is Owner and has the following contact phone number (312) 519-1465.

The enumeration date for this NPI number is 5/14/2008 and was last updated on 11/6/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/Center03610878ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1H89366MEDICARE UPINILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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