Physicians Laser and Dermatology Institute of Chicago LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PHYSICIANS LASER AND DERMATOLOGY INSTITUTE OF CHICAGO LLC

Practice address

150 E Huron St Ste 1200
Chicago, IL 60611-2949

Phone

(312) 280-0890

Fax

(312) 280-9615

NPI assigned

Feb 6, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jerome M Garden, M.D.NPI 1326187295

Title

Owner

Phone

(312) 280-0890

Specialties & licenses 1

Addresses

Other names 1

• Jerome M. Garden, M.D. Former legal business name

Practitioners 1

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.

• Jerome Mark Garden, M.D.

  • Dermatology Physician
  • Chicago, IL
  • NPI 1326187295
  Authorized official Same address or phone

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1366581993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "150 E HURON ST STE 1200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112949",
            "telephone_number": "312-280-0890",
            "fax_number": "312-280-9615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 E HURON ST STE 1200",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606112949",
            "telephone_number": "312-280-0890",
            "fax_number": "312-280-9615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIANS LASER AND DERMATOLOGY INSTITUTE OF CHICAGO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GARDEN",
        "authorized_official_first_name": "JEROME",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "312-280-0890",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jerome M. Garden, M.D.",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• 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.