Elk Grove Dermatology, S.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

ELK GROVE DERMATOLOGY, S.C.

Practice address

901 Biesterfield Rd Ste 209
Elk Grove Village, IL 60007-7300

Phone

(847) 593-6222

NPI assigned

Mar 20, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Robert B Polisky, M.D.

Title

Sole Propiertor

Phone

(847) 593-6222

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Jaspreet Singh Nanra, MD

  • Family Medicine Physician
  • Merced, CA
  • NPI 1982055760

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193270400000",
    "number": "1386769271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 BIESTERFIELD RD STE 209",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600077300",
            "telephone_number": "847-593-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 BIESTERFIELD RD STE 209",
            "city": "ELK GROVE VILLAGE",
            "state": "IL",
            "postal_code": "600077300",
            "telephone_number": "847-593-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELK GROVE DERMATOLOGY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-10-25",
        "status": "A",
        "authorized_official_last_name": "POLISKY",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "SOLE PROPIERTOR",
        "authorized_official_telephone_number": "847-593-6222",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "916-120",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ela Pharmacy LLC
• Elizabeth Pacocha DPM PC
• Elk Grove Cardiology Associates
• Elk Grove Dental Care
• Elk Grove Dental, LLC
• Elk Grove Imaging Associates, S.C.
• Elk Grove Internal Medicine Associates, S.C.
• Elk Grove Lab Physicians, P.C.
• Elk Grove Medical Associates, LLC
• Elk Grove MRI Inc.

• Dermatology Physician in Elk Grove Village, IL
• Providers in Elk Grove Village, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2007; 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.