Dermatology and Aesthetics of Wicker Park, PLLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

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

Last updated

Jan 8, 2021By 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

Neha Robinson, MDNPI 1669407052

Title

Owner/ Physician

Phone

(773) 276-1100

Specialties & licenses 1

Addresses

Other names 1

• Dermatology and Aesthetics of Wicker Park, LLC Former legal business name

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 5

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.

• Neha Robinson, M.D.

  • Dermatology Physician
  • Chicago, IL
  • NPI 1669407052
  Authorized official Same address or phone
• Jeremy Scott Youse, MD

  • MOHS-Micrographic Surgery Physician
  • Urbana, IL
  • NPI 1538289012

  Dermatology

  NPD
• Ryan Bunney

  • Dermatology Physician
  • Chicago, IL
  • NPI 1871171157
  NPD (past)
• Michael Scott Pomroy, M.D.

  • Dermatology Physician
  • Madison, WI
  • NPI 1235396425
  NPD (past)
• Alissa Steele, PA-C

  • Physician Assistant
  • Sault Sainte Marie, MI
  • NPI 1750833513
  NPD (past)

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"
        }
    ]
}

• Claire Adaora Derksen
• Benjamin Derman
• Daniel M Derman, M.D.
• Gordon Harris Derman, M. D.
• Yael Emily Derman, CPNP-AC
• Dermatology Consultants LTD
• Dermatology Physicians Group, LLC
• Dermatology Physicians SC
• Dermatology Specialist, LTD
• Dermatology-Chicago S C

• 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 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.

Verify at the official NPI Registry.