ELITE DERMATOLOGY PLLC NPI 1619890571

NPI Information

  • NPI: 1619890571
  • Provider Name: ELITE DERMATOLOGY PLLC
  • Classification: Dermatology - 207N00000X
  • Entity Type: Organization
  • Address: 3000 N HALSTED ST STE 500
    CHICAGO, IL
    ZIP 60657
  • Phone: (773) 871-7000

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NPI Details

ELITE DERMATOLOGY PLLC 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. ELITE DERMATOLOGY PLLC NPI is 1619890571. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3000 N HALSTED ST STE 500
CHICAGO, IL
ZIP 60657-194
Phone: (773) 871-7000

The provider's authorized official is Edward Prodanovic .
The authorized official title is Owner and has the following contact phone number (415) 802-1310.

The enumeration date for this NPI number is 7/30/2026 and was last updated on 7/30/2026.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207N00000XDermatologyYes
2207ND0101XDermatologyMOHS-Micrographic SurgeryNo

What is NPI?

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This page was last updated on: 11/21/2025

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