Dermatology-Chicago S C

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036064577 Issued in IL

Legal business name

DERMATOLOGY-CHICAGO S C

Practice address

25 E Washington St
Suite 1131
Chicago, IL 60602-1708

Phone

(312) 372-0150

Fax

(312) 372-4249

NPI assigned

Nov 18, 2009

Last updated

Dec 2, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David Bryan Shanker, M.D.NPI 1619905734

Title

Owner

Phone

(312) 372-0150

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• David Bryan Shanker, M.D.

  • Dermatology Physician
  • Chicago, IL
  • NPI 1619905734
  Authorized official Same address or phone

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

{
    "created_epoch": "1258502400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259712000000",
    "number": "1023345758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 E WASHINGTON ST",
            "address_2": "SUITE 1131",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021708",
            "telephone_number": "312-372-0150",
            "fax_number": "312-372-4249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 E WASHINGTON ST",
            "address_2": "SUITE 1131",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021708",
            "telephone_number": "312-372-0150",
            "fax_number": "312-372-4249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY-CHICAGO S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-18",
        "last_updated": "2009-12-02",
        "status": "A",
        "authorized_official_last_name": "SHANKER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "BRYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-372-0150",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036064577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dermatology and Aesthetics of Wicker Park, PLLC
• Dermatology Consultants LTD
• Dermatology Physicians Group, LLC
• Dermatology Physicians SC
• Dermatology Specialist, LTD
• Shannon B Dermer, PH.D.
• Patrick Artin Dermesropian, D.D.S.
• Dermio, LLC
• Mel A Dermody, H.I.D.
• Lia Deroin, MD

• Dermatology Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2009; 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.