NPIMap

Organization Active NPI

Adult & Pediatric Dermatology of Naperville, LTD.

  • Dermatology Physician
  • Naperville, IL
National Provider Identifier
1336396563
Registry record updated Nov 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036-076923 Issued in IL
Legal business name
ADULT & PEDIATRIC DERMATOLOGY OF NAPERVILLE, LTD.
Practice address
120 Spalding Dr
Suite 401
Naperville, IL 60540-6508
Phone
(630) 369-3376
Fax
(630) 369-8838
NPI assigned
Aug 19, 2008
Last updated
Nov 19, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2008

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

Authorized official

Name
Dr. Colleen Ann Keegan
Title
D.O.
Phone
(630) 369-3376

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 036-076923 IL Primary

Addresses

Primary practice location

120 Spalding Dr
Suite 401
Naperville, IL 60540-6508

Mailing address

120 Spalding Dr
Suite 401
Naperville, IL 60540-6508
Phone (630) 369-3376

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227052800000",
    "number": "1336396563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 SPALDING DR",
            "address_2": "SUITE 401",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406508",
            "telephone_number": "630-369-3376",
            "fax_number": "630-369-8838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 SPALDING DR",
            "address_2": "SUITE 401",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605406508",
            "telephone_number": "630-369-3376",
            "fax_number": "630-369-8838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADULT & PEDIATRIC DERMATOLOGY OF NAPERVILLE, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2008-11-19",
        "status": "A",
        "authorized_official_last_name": "KEEGAN",
        "authorized_official_first_name": "COLLEEN",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "D.O.",
        "authorized_official_telephone_number": "630-369-3376",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036-076923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Naperville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.