Skin Wellness Center of Chicago, SC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

SKIN WELLNESS CENTER OF CHICAGO, SC

Practice address

111 N Wabash Ave
Suite # 1116
Chicago, IL 60602-1903

Phone

(312) 236-9950

Fax

(312) 236-9951

NPI assigned

May 6, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Brooke A. Jackson, MD

Title

President, Owner, Medical Director

Phone

(312) 236-9950

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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.

• Lalitha D Reddy, MD

  • Dermatology Physician
  • Downers Grove, IL
  • NPI 1053306597
  NPD (past)
• Cecelia H. Ricketts, M.D.

  • Clinical & Laboratory Dermatological Immunology Physician
  • Wilmette, IL
  • NPI 1689799454
  NPD (past)

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

{
    "created_epoch": "1178409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356553754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE",
            "address_2": "SUITE # 1116",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021903",
            "telephone_number": "312-236-9950",
            "fax_number": "312-236-9951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 N WABASH AVE",
            "address_2": "SUITE # 1116",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606021903",
            "telephone_number": "312-236-9950",
            "fax_number": "312-236-9951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SKIN WELLNESS CENTER OF CHICAGO, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "BROOKE",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "PRESIDENT, OWNER, MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "312-236-9950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonidas F Skiadopoulos
• Demetrios D Skias, M.D.
• Katerina Skiba, CCC-SLP
• Rohen Nowak Skiba, BSC, MBBS, FRACS
• Lindsay Marie Skibley, M.D.
• Skinio Services, S.C.
• Brian Skinner, LCSW
• James Skinner
• Kelly A Skinner, RN, MSN, FNP-BC
• Nicole Skinnion

• 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 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.