Organization Active NPI

Ab Dermatology LLC

  • Dermatology Physician
  • Arlington Heights, IL
National Provider Identifier
1285043646
Registry record updated Aug 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
AB DERMATOLOGY LLC
Practice address
3060 N Arlington Heights Rd
Arlington Heights, IL 60004-1530
Phone
(847) 394-1202
Fax
(847) 394-3674
NPI assigned
Aug 10, 2014
Last updated
Aug 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2014

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

Authorized official

Name
Suleman Bangash, D.O.NPI 1942302864
Title
Doctor
Phone
(224) 542-9942

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

3060 N Arlington Heights Rd
Arlington Heights, IL 60004-1530

Mailing address

3060 N Arlington Heights Rd
Arlington Heights, IL 60004-1530
Phone (847) 394-1202

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141209002201 IL Part B Supplier - Clinic/Group Practice 4789906322 Receives reassigned benefits from 18 practitioners
Practice locations: Yorkville, IL; Des Plaines, IL; Bloomingdale, IL; Arlington Heights, IL; Aurora, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D1093233Ab Dermatology3060 N Arlington Heights Rd, Arlington Heights, IL 60004ComplianceJul 13, 2027

National Provider Directory

National Provider Directory

Locations

3973 75th St
Ste 103
Aurora, IL 60504
Phone (630) 499-8999

1455 E Golf Rd
Ste 104
Des Plaines, IL 60016
Phone (847) 699-3101

200 Garden St
Yorkville, IL 60560
Phone (630) 882-8300

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1407628800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407628800000",
    "number": "1285043646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 N ARLINGTON HEIGHTS RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600041530",
            "telephone_number": "847-394-1202",
            "fax_number": "847-394-3674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3060 N ARLINGTON HEIGHTS RD",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600041530",
            "telephone_number": "847-394-1202",
            "fax_number": "847-394-3674"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AB DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-10",
        "last_updated": "2014-08-10",
        "status": "A",
        "authorized_official_last_name": "BANGASH",
        "authorized_official_first_name": "SULEMAN",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "224-542-9942",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington Heights, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2014; 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.