Aesthetic Dermatology Jonith Y Breadon MD LTD

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

Legal business name

AESTHETIC DERMATOLOGY JONITH Y BREADON MD LTD

Practice address

1009 W Fulton Market
Chicago, IL 60607-1222

Phone

(312) 733-2492

Fax

(312) 733-2498

NPI assigned

Feb 22, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jonith Breadon, MD

Title

Owner-Proprietor-Head Physician

Phone

(312) 733-2498

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 3

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

• Nilam Kiran Amin, D.O.

  • Dermatology Physician
  • Chicago, IL
  • NPI 1619907995
  NPD (past)
• Margaret Romano, PA-C

  • Physician Assistant
  • Chicago, IL
  • NPI 1518391283
  NPD (past)
• Nina Rusiana, APN

  • Family Nurse Practitioner
  • Villa Park, IL
  • NPI 1376828194
  NPD (past)

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1225163967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 W FULTON MARKET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071222",
            "telephone_number": "312-733-2492",
            "fax_number": "312-733-2498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 W FULTON MARKET",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606071222",
            "telephone_number": "312-733-2492",
            "fax_number": "312-733-2498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AESTHETIC DERMATOLOGY JONITH Y BREADON MD LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-22",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "BREADON",
        "authorized_official_first_name": "JONITH",
        "authorized_official_title_or_position": "OWNER-PROPRIETOR-HEAD PHYSICIAN",
        "authorized_official_telephone_number": "312-733-2498",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "31602551",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aerodyne Technologies LLC
• Shannon Aeschliman, LPC
• Aesthetic Dental Solutions, P.C.
• Aesthetic Dental Solutions, P.C.
• Aesthetic Dermatology
• Aesthetic Institute of Chicago, S.C.
• Aesthetics Unlimited, PLLC
• Af Influx Inc
• Walter P Afable, CP
• Andrew Gumban Afante, DPT

• Medical Specialty Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Medical Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.