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SOUTHWEST DERMATOLOGY PC NPI 1235374919


NPI Information

NPI: 1235374919
Provider Name: SOUTHWEST DERMATOLOGY, PC
Classification: Dermatology - 207N00000X
Entity Type: Organization
Address:
7123 W ARCHER AVE
CHICAGO, IL
ZIP 60638
Phone: (773) 586-4506
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SOUTHWEST DERMATOLOGY, PC is a dermatology in Chicago, IL. The provider is 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. SOUTHWEST DERMATOLOGY, PC NPI is 1235374919. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

7123 W ARCHER AVE
CHICAGO, IL
ZIP 60638-203
Phone: (773) 586-4506

The provider's authorized official is Julie Moreno .
The authorized official title is Credentialing Specialist and has the following contact phone number (773) 586-4506.

The enumeration date for this NPI number is 12/9/2008 and was last updated on 12/9/2008.


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
1363L00000XNurse PractitionerILLINOISNo
2207N00000XDermatologyILLINOISYes

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
1I22305OTHERUPIN
2L99550MEDICARE UPIN
3D14504OTHERILLINOISUPIN
4L99553MEDICARE UPIN
5H88109OTHERUPIN
6R01258MEDICARE UPIN
7I60050OTHERUPIN
8P60539OTHERUPIN
9K07403MEDICARE UPIN
10K02052MEDICARE UPIN
11K16089MEDICARE UPIN
12036059742MEDICAIDILLINOIS
13206248MEDICARE PIN

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: 4/28/2024

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