Kaminska Dermatology PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

KAMINSKA DERMATOLOGY PLLC

Practice address

3808 N Lincoln Ave
Suite 101
Chicago, IL 60613

Phone

(773) 677-4300

Fax

(773) 423-8429

NPI assigned

Sep 30, 2019

Organization subpart

No

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

Authorized official

Name

Edidiong Kaminska, MDNPI 1407083496

Title

Medical Director and Founder

Phone

(773) 677-4300

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 5

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

• Edidiong Kaminska, M.D.

  • Dermatology Physician
  • Chicago, IL
  • NPI 1407083496
  Medicare reassignment Care Compare group NPD Authorized official
• Priyanka D Patel, MD

  • Dermatology Physician
  • Gahanna, OH
  • NPI 1912469834

  IL

  Medicare reassignment Care Compare group NPD
• Beth Ann Adams, M.D.

  • Dermatology Physician
  • Chicago, IL
  • NPI 1376751255

  Single Specialty

  Medicare reassignment NPD
• Hanna Block, PA-C

  • Physician Assistant
  • Chicago, IL
  • NPI 1821612532
  Medicare reassignment
• Katherine Petersen, PA

  • Physician Assistant
  • Chicago, IL
  • NPI 1720705957
  Medicare reassignment

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693180800000",
    "number": "1265073415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 N ASHLAND AVE UNIT 577452",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606577783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 N LINCOLN AVE",
            "address_2": "SUITE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60613",
            "telephone_number": "773-677-4300",
            "fax_number": "773-423-8429"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 E Erie St Ste 530",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112792",
            "country_code": "US",
            "telephone_number": "773-677-4300",
            "fax_number": "773-423-8429",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KAMINSKA DERMATOLOGY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-30",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A",
        "authorized_official_last_name": "KAMINSKA",
        "authorized_official_first_name": "EDIDIONG",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR AND FOUNDER",
        "authorized_official_telephone_number": "773-677-4300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "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.kaminskadermatology.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": []
}

• Jennifer Kamieniak, DPT
• Michelle Kamin-Lindsay, LCSW
• Kelsey Kamin
• Maryn Kamin, FNP
• Kaminska Dermatology
• Edidiong Kaminska, M.D.
• Brittany Kaminski, PT, DPT
• Chris Kaminski, PT, DPT
• Jan Pawel Kaminski, MD
• Kevin Kaminski

• 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 Aug 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.