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MAVENA DERMA CENTERS INC. NPI 1396768727


NPI Information

NPI: 1396768727
Provider Name: MAVENA DERMA CENTERS, INC.
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1100 W CENTRAL RD
306
ARLINGTON HEIGHTS, IL
ZIP 60005
Phone: (847) 483-9621
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MAVENA DERMA CENTERS, INC. is a specialist in Arlington Heights, IL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MAVENA DERMA CENTERS, INC. NPI is 1396768727. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1100 W CENTRAL RD
306
ARLINGTON HEIGHTS, IL
ZIP 60005-402
Phone: (847) 483-9621
Fax: (847) 483-9625

The provider's authorized official is Jerri Mcginnis .
The authorized official title is Vice President and has the following contact phone number (847) 483-9621.

The enumeration date for this NPI number is 7/26/2006 and was last updated on 11/28/2007.


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
1174400000XSpecialistYes

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
101636236OTHERILLINOISBCBS
2214157MEDICARE PINILLINOIS

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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