University Dermatology and Vein Clinic LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

UNIVERSITY DERMATOLOGY AND VEIN CLINIC LLC

Practice address

8110 Cass Ave
Darien, IL 60561-5013

Phone

(773) 351-2862

NPI assigned

Aug 24, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Vassilios Athanasios Dimitropoulos, M.D.NPI 1194838045

Title

Physician/ Owner/ President

Phone

(773) 351-2862

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

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

Interoperability endpoints

• FHIR API: https://fhir-myrecord.cerner.com/r4/J3trBeALwJU1F3hepm2v21jJ96hxu50P/

Practitioners 8

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

• Vassilios A. Dimitropoulos, M.D.

  • Dermatology Physician
  • Michigan City, IN
  • NPI 1194838045

  IL

  Medicare reassignment Care Compare group NPD Authorized official
• Benjamin C Garden, M.D.

  • Dermatology Physician
  • Skokie, IL
  • NPI 1699193334
  Medicare reassignment Care Compare group NPD
• Joshua O Podjasek, M.D.

  • Dermatology Physician
  • Darien, IL
  • NPI 1245496850
  Medicare reassignment Care Compare group NPD
• Elizabeth Marie Zanone, PA

  • Dermatology Physician
  • Darien, IL
  • NPI 1982172599
  Medicare reassignment Care Compare group
• Noor Tazudeen, M.D.

  • Dermatology Physician
  • Chicago, IL
  • NPI 1366857286
  Medicare reassignment NPD
• Maria Magdalene Tsoukas, M.D., PH.D.

  • Dermatology Physician
  • Chicago, IL
  • NPI 1083689137
  Medicare reassignment NPD
• Stephanie Wang

  • Dermatology Physician
  • Chicago, IL
  • NPI 1215321468
  Medicare reassignment NPD
• Karen A Smith, P.A.

  • Physician Assistant
  • Darien, IL
  • NPI 1922287614
  Medicare reassignment

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471996800000",
    "number": "1194270637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 S PARK AVE",
            "city": "HINSDALE",
            "state": "IL",
            "postal_code": "605214645",
            "telephone_number": "773-351-2862",
            "fax_number": "773-358-2767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8110 CASS AVE",
            "city": "DARIEN",
            "state": "IL",
            "postal_code": "605615013",
            "telephone_number": "773-351-2862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNIVERSITY DERMATOLOGY AND VEIN CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-24",
        "last_updated": "2016-08-24",
        "status": "A",
        "authorized_official_last_name": "DIMITROPOULOS",
        "authorized_official_first_name": "VASSILIOS",
        "authorized_official_middle_name": "ATHANASIOS",
        "authorized_official_title_or_position": "PHYSICIAN/ OWNER/ PRESIDENT",
        "authorized_official_telephone_number": "773-351-2862",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology, Procedural Dermatology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194838045",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Adriana P Trosper
• Chez Tyson
• Marcia L Ublies
• Ariadna Ugalde-Rivero
• Ashleigh Ulrich, BCBA
• University Medicine and Cardiology
• Demi Cagney Van Wyk
• Shinu Philip Varghese, O.D.
• Jodie Velez
• Rachel Verdi

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2016; 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.