NPIMap

Organization Active NPI

Bielinski Dermatology Group, LLC

  • Dermatology Physician
  • Orland Park, IL
National Provider Identifier
1366497554
Registry record updated Mar 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036-070977 Issued in IL
Legal business name
BIELINSKI DERMATOLOGY GROUP, LLC
Practice address
16105 S la Grange Rd
Orland Park, IL 60467-5503
Phone
(708) 636-3767
Fax
(708) 636-4361
NPI assigned
May 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2025

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

Authorized official

Name
Lawrence Lazelle Anderson, MDNPI 1134159627
Title
Medical Director
Phone
(903) 521-6143

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 036-070977 IL Primary

Addresses

Primary practice location

16105 S la Grange Rd
Orland Park, IL 60467-5503

Mailing address

16105 S la Grange Rd
Orland Park, IL 60467-5503
Phone (708) 636-3767

Other practice location 1

3900 W 95th St Ste 12
Evergreen Park, IL 60805-1901
Phone (708) 636-3767

Other names 1

  • SkinMD, LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060705000103 IL Part B Supplier - Clinic/Group Practice 6406868769 Receives reassigned benefits from 16 practitioners
Practice locations: Chicago, IL; Evergreen Park, IL; Orland Park, IL; Skokie, IL; Willowbrook, IL

National Provider Directory

National Provider Directory

Locations

104 N White St
Frankfort, IL 60423

4711 Golf Rd
Ste 807
Skokie, IL 60076
Phone (708) 636-3767

Practitioners & affiliated clinicians

Practitioners 16

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

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741564800000",
    "number": "1366497554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16105 S LA GRANGE RD",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675503",
            "telephone_number": "708-636-3767",
            "fax_number": "708-636-4361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16105 S LA GRANGE RD",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604675503",
            "telephone_number": "708-636-3767",
            "fax_number": "708-636-4361"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3900 W 95th St Ste 12",
            "address_purpose": "LOCATION",
            "city": "Evergreen Park",
            "state": "IL",
            "postal_code": "608051901",
            "country_code": "US",
            "telephone_number": "708-636-3767",
            "fax_number": "708-636-4361",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BIELINSKI DERMATOLOGY GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2025-03-10",
        "certification_date": "2025-03-10",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "LAZELLE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "903-521-6143",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036-070977",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SkinMD, LLC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "SkinMD, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.