NPIMap

Organization Active NPI

Jessie Cheung Dermatology, SC

  • Dermatology Physician
  • Willowbrook, IL
National Provider Identifier
1003280272
Registry record updated Nov 25, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036-112811 Issued in IL
Legal business name
JESSIE CHEUNG DERMATOLOGY, SC
Practice address
545 Plainfield Rd
Suite B
Willowbrook, IL 60527-7600
Phone
(312) 415-8115
NPI assigned
Nov 25, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jessie Cheung
Title
Credentialing
Phone
(630) 928-5234

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 036-112811 IL Primary

Addresses

Primary practice location

545 Plainfield Rd
Suite B
Willowbrook, IL 60527-7600

Mailing address

545 Plainfield R.
Suite B
Willowbrook, IL 60527

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1448409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448409600000",
    "number": "1003280272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 PLAINFIELD R.",
            "address_2": "SUITE B",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "60527"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 PLAINFIELD RD",
            "address_2": "SUITE B",
            "city": "WILLOWBROOK",
            "state": "IL",
            "postal_code": "605277600",
            "telephone_number": "312-415-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSIE CHEUNG DERMATOLOGY, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-25",
        "last_updated": "2015-11-25",
        "status": "A",
        "authorized_official_last_name": "CHEUNG",
        "authorized_official_first_name": "JESSIE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "630-928-5234"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036-112811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Willowbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.