Medical Surgical Dermatology, SC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

MEDICAL SURGICAL DERMATOLOGY, SC

Practice address

3253 Harlem Ave
Berwyn, IL 60402-2996

Phone

(708) 788-3885

Fax

(708) 788-6885

NPI assigned

Nov 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. David H Whitney, MD

Title

President

Phone

(708) 788-3885

Specialties & licenses 2

Addresses

Locations

Practitioners 2

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

• Juliana Yong Hae Chyu, M.D.

  • Dermatology Physician
  • Crystal Lake, IL
  • NPI 1609972124
  NPD (past)
• Lidia S Pomaville, PA-C

  • Physician Assistant
  • Berwyn, IL
  • NPI 1144595174
  NPD (past)

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316014723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3253 HARLEM AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022996",
            "telephone_number": "708-788-3885",
            "fax_number": "708-788-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3253 HARLEM AVE",
            "city": "BERWYN",
            "state": "IL",
            "postal_code": "604022996",
            "telephone_number": "708-788-3885",
            "fax_number": "708-788-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL SURGICAL DERMATOLOGY, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WHITNEY",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-788-3885",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer M McFee, PHARMD, CDM
• Timothy K McGonagle, M.D,
• McKenna Physical Therapy and Wellness PLLC
• Corinne T McKenna
• Alexandria Z Meccia, MD
• Kathleen Patricia Medici, APN
• Medicor Partners, S.C
• Vanessa Medina, DMD
• Yvette Medina, LCPC, CADC, CAMS II
• Marcel Melo

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.