Chicago Cosmetic Surgery and Dermatology SC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036-102098 Issued in IL

Legal business name

CHICAGO COSMETIC SURGERY AND DERMATOLOGY SC

Practice address

515 N State St Ste 900
Chicago, IL 60654-9104

Phone

(312) 245-9965

Fax

(312) 245-9964

NPI assigned

May 4, 2007

Last updated

Apr 14, 2026By 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

Carolyn JacobNPI 1265498083

Title

Medical Director

Phone

(312) 245-9965

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

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 8

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.

• Carolyn Jacob, MD

  • Dermatology Physician
  • Chicago, IL
  • NPI 1265498083
  Medicare reassignment Care Compare group Authorized official
• Jennifer Croix, MD, PHD

  • Dermatology Physician
  • Northbrook, IL
  • NPI 1144596628
  Medicare reassignment Care Compare group NPD
• Toral Dilip Patel, MD

  • Dermatology Physician
  • Lombard, IL
  • NPI 1346409919
  Medicare reassignment Care Compare group NPD
• Joy Tao, MD

  • Dermatology Physician
  • Hines, IL
  • NPI 1992365696
  Medicare reassignment Care Compare group NPD
• Solomiya Grushchak, MD

  • Dermatology Physician
  • San Diego, CA
  • NPI 1588168108

  IL

  Medicare reassignment Care Compare group NPD
• Whitney C Hersh, PA-C

  • Physician Assistant
  • Chicago, IL
  • NPI 1972055507
  Medicare reassignment Care Compare group
• Caroline Sheppard, PA-C

  • Physician Assistant
  • Chicago, IL
  • NPI 1144732140
  Medicare reassignment Care Compare group
• Nicoletta Stefina Ciraulo, PA-C

  • Dermatology Physician
  • Ann Arbor, MI
  • NPI 1326674441

  IL

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776124800000",
    "number": "1407068000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 N STATE ST STE 900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606549104",
            "telephone_number": "312-245-9965",
            "fax_number": "312-245-9964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N STATE ST STE 900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606549104",
            "telephone_number": "312-245-9965",
            "fax_number": "312-245-9964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO COSMETIC SURGERY AND DERMATOLOGY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2026-04-14",
        "certification_date": "2026-04-14",
        "status": "A",
        "authorized_official_last_name": "JACOB",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "312-245-9965"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036-102098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1634805",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Chicago Commons Association
• Chicago Community Medical Center
• Chicago Compass Counseling, LLC
• Chicago Conservative Care, Inc.
• Chicago Consultant Pharmacists, LLC
• Chicago Cosmetic Surgery Institute
• Chicago Counseling Associates
• Chicago Counseling Cafe PLLC
• Chicago Counseling Center, P.C.
• Chicago Counseling Center, P.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 Apr 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.