Active NPI
Dermatology and Aesthetics of Wicker Park, PLLC
- Dermatology Physician
- Chicago, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- Legal business name
- DERMATOLOGY AND AESTHETICS OF WICKER PARK, PLLC
- Practice address
- 1765 N Elston Ave
Suite 110
Chicago, IL 60642-1501 - Phone
- (773) 276-1100
- Fax
- (773) 276-1102
- NPI assigned
- Mar 13, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Neha Robinson, MD
- Title
- Owner/ Physician
- Phone
- (773) 276-1100
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | Primary |
Addresses
Primary practice location
1765 N Elston Ave
Suite 110
Chicago, IL 60642-1501
Mailing address
1765 N Elston Ave
Suite 110
Chicago, IL 60642-1501
Phone (773) 276-1100
Other names 1
- Dermatology and Aesthetics of Wicker Park, LLC
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D1066591 | Dermatology & Aesthetics, Wicker Park | Provider-performed microscopy | May 7, 2027 |
National Provider Directory
National Provider DirectoryLocations
1733 N Harlem Ave
Chicago, IL 60707
Phone (773) 237-6666
1455 N Milwaukee Ave
#2
Chicago, IL 60622
Phone (773) 276-1100
541 N Fairbanks Ct
Ste 1450
Chicago, IL 60611
680 N Lake Shore Dr
#D
Chicago, IL 60611
1765 N Elston Ave
Chicago, IL 60642
Phone (312) 399-0370
1765 N Elston Ave
Ste 110
Chicago, IL 60642
Phone (773) 276-1100
Practitioners & affiliated clinicians
Practitioners 4
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Dermatology Physician
- Chicago, IL
- NPI 1871171157
-
- Dermatology Physician
- Madison, WI
- NPI 1235396425
-
- Physician Assistant
- Sault Sainte Marie, MI
- NPI 1750833513
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1610064000000",
"number": "1386777241",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1765 N ELSTON AVE",
"address_2": "SUITE 110",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606421501",
"telephone_number": "773-276-1100",
"fax_number": "773-276-1102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1765 N ELSTON AVE",
"address_2": "SUITE 110",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606421501",
"telephone_number": "773-276-1100",
"fax_number": "773-276-1102"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DERMATOLOGY AND AESTHETICS OF WICKER PARK, PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-13",
"last_updated": "2021-01-08",
"certification_date": "2021-01-08",
"status": "A",
"authorized_official_last_name": "ROBINSON",
"authorized_official_first_name": "NEHA",
"authorized_official_title_or_position": "OWNER/ PHYSICIAN",
"authorized_official_telephone_number": "773-276-1100",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dermatology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Dermatology and Aesthetics of Wicker Park, LLC",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.