Dermatology Consultants LTD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

03629454 Issued in IL

Legal business name

DERMATOLOGY CONSULTANTS LTD

Practice address

6374 N Lincoln Ave
Suite 202
Chicago, IL 60659

Phone

(773) 267-8820

Fax

(773) 583-2118

NPI assigned

Oct 29, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Irving H Disteliteim, MD

Title

President

Phone

(773) 267-8820

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1295914174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6374 N LINCOLN AVE",
            "address_2": "SUITE 202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60659",
            "telephone_number": "773-267-8820",
            "fax_number": "773-583-2118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6374 N LINCOLN AVE",
            "address_2": "SUITE 202",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60659",
            "telephone_number": "773-267-8820",
            "fax_number": "773-583-2118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY CONSULTANTS LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-29",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "DISTELITEIM",
        "authorized_official_first_name": "IRVING",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-267-8820",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "03629454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1615765",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Benjamin Derman
• Daniel M Derman, M.D.
• Gordon Harris Derman, M. D.
• Yael Emily Derman, CPNP-AC
• Dermatology and Aesthetics of Wicker Park, PLLC
• Dermatology Physicians Group, LLC
• Dermatology Physicians SC
• Dermatology Specialist, LTD
• Dermatology-Chicago S C
• Shannon B Dermer, PH.D.

• 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 Oct 29, 2007; 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.