Dermatology Specialist, LTD

Primary specialty

SpecialistTaxonomy code 174400000X

License

036035278 Issued in IL

Legal business name

DERMATOLOGY SPECIALIST, LTD

Practice address

2740 W Foster Ave Suite 305
Chicago, IL 60625

Phone

(773) 271-4442

Fax

(773) 271-4474

NPI assigned

Oct 2, 2006

Organization subpart

No

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

Authorized official

Name

Barry Kirschenbaum, M.D

Title

Physician

Phone

77332714442

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210636800000",
    "number": "1255424552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE SUITE 305",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60625",
            "telephone_number": "773-271-4442",
            "fax_number": "773-271-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2740 W FOSTER AVE SUITE 305",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60625",
            "telephone_number": "773-271-4442",
            "fax_number": "773-271-4474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY SPECIALIST, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2008-05-13",
        "status": "A",
        "authorized_official_last_name": "KIRSCHENBAUM",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "77332714442",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": "036035278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036035278",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAIL ROAD MEDICARE",
            "identifier": "DG9713",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yael Emily Derman, CPNP-AC
• Dermatology and Aesthetics of Wicker Park, PLLC
• Dermatology Consultants LTD
• Dermatology Physicians Group, LLC
• Dermatology Physicians SC
• Dermatology-Chicago S C
• Shannon B Dermer, PH.D.
• Patrick Artin Dermesropian, D.D.S.
• Dermio, LLC
• Mel A Dermody, H.I.D.

• Specialist in Chicago, IL
• Providers in Chicago, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 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.