Forefront Dermatology, S.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

FOREFRONT DERMATOLOGY, S.C.

Practice address

331 W Surf St Ste 700
Chicago, IL 60657-0083

Phone

(773) 832-7443

Fax

(773) 295-4126

NPI assigned

Oct 24, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Betsy J Wernli, MD

Title

President

Phone

(920) 482-0671

Specialties & licenses 3

Addresses

Other names 1

• Conrad Petersen Dermatology, A Forefront Dermatology Practice Doing business as

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Other NPIs on the same Medicare enrollment 21

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Forefront Dermatology SC

  • Dermatology Physician
  • Chicago, IL
  • NPI 1972461028

  O20151130001424

  Same enrollment
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Crest Hill, IL
  • NPI 1053783308

  O20151130001424

  Same enrollment
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Park Ridge, IL
  • NPI 1053994004

  O20151130001424

  Same enrollment
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Gurnee, IL
  • NPI 1124730312

  O20151130001424

  Same enrollment
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • New Lenox, IL
  • NPI 1154793412

  O20151130001424

  Same enrollment
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Chicago, IL
  • NPI 1184515264

  O20151130001424

  Same enrollment
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Wheaton, IL
  • NPI 1194462382

  O20151130001424

  Same enrollment
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Chicago, IL
  • NPI 1235685256

  O20151130001424

  Same enrollment
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Sycamore, IL
  • NPI 1356072243

  O20151130001424

  Same enrollment
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Naperville, IL
  • NPI 1376915629

  O20151130001424

  Same enrollment
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Grayslake, IL
  • NPI 1427589027

  O20151130001424

  Same enrollment
• Forefront Dermatology, S.C.

  • Dermatology Physician
  • Yorkville, IL
  • NPI 1528430881

  O20151130001424

  Same enrollment

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lauren Agostinacchio, PA-C

  • Physician Assistant
  • Chicago, IL
  • NPI 1831779933

  Multi-Specialty

  NPD

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

{
    "created_epoch": "1729728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729728000000",
    "number": "1083436711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 YORK ST",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542204630",
            "telephone_number": "920-663-9008",
            "fax_number": "920-684-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 W SURF ST STE 700",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606570083",
            "telephone_number": "773-832-7443",
            "fax_number": "773-295-4126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOREFRONT DERMATOLOGY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-24",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A",
        "authorized_official_last_name": "WERNLI",
        "authorized_official_first_name": "BETSY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "920-482-0671",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Conrad Petersen Dermatology, A Forefront Dermatology Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Julia Cibul Fording, MSW
• Ama Fordwor-Koranteng, MD
• Jerome C Fore
• Peter F. Fore, M.D.
• Forefront Dermatology SC
• Forefront Dermatology, S.C.
• Forefront Dermatology, S.C.
• Forefront Healthcare Solutions, Inc.
• Foreigntouch by Dolly
• Amber Foreman, LCSW

• All providers in Chicago, IL
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.