Kaminska Dermatology

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

KAMINSKA DERMATOLOGY

Doing business as

Kaminska Dermatology

Practice address

3000 N Halsted St Ste 724
Chicago, IL 60657-5196

Phone

(708) 628-7771

NPI assigned

Jul 2, 2019

Last updated

Sep 2, 2019By 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. Edidiong Kaminska, MD

Title

President

Phone

(901) 907-9820

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Kaminska Dermatology Doing business as

Electronic endpoints 1

Locations

Interoperability endpoints

• FHIR API: https://app.meldrx.com/api/fhir/ez_00174

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

{
    "created_epoch": "1562025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567382400000",
    "number": "1093377731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1776 N MILWAUKEE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606475453",
            "telephone_number": "312-926-3627",
            "fax_number": "773-862-1454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 N HALSTED ST STE 724",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606575196",
            "telephone_number": "708-628-7771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3803 N Lincoln Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606133519",
            "country_code": "US",
            "telephone_number": "708-628-7771",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KAMINSKA DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-09-02",
        "status": "A",
        "authorized_official_last_name": "KAMINSKA",
        "authorized_official_first_name": "EDIDIONG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-907-9820",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1407083496",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.mochaderm.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "address_1": "3000 N Halsted St Ste 724",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606575196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Kaminska Dermatology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Kaminska Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Miriam R Kamid, O.T.
• Jennifer Kamieniak, DPT
• Michelle Kamin-Lindsay, LCSW
• Kelsey Kamin
• Maryn Kamin, FNP
• Kaminska Dermatology PLLC
• Edidiong Kaminska, M.D.
• Brittany Kaminski, PT, DPT
• Chris Kaminski, PT, DPT
• Jan Pawel Kaminski, 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 Sep 2, 2019; 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.