Dermatology Centers, SC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DERMATOLOGY CENTERS, SC

Practice address

183 Heritage Dr
Crystal Lake, IL 60014-8042

Phone

(815) 455-4434

NPI assigned

Mar 19, 2007

Last updated

Oct 22, 2007By 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

David P Van Dam, MDNPI 1992877278

Title

Owner

Phone

(847) 382-5111

Specialties & licenses 1

Addresses

Locations

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.

• David Paul Van Dam, M.D.

  • Dermatology Physician
  • Barrington, IL
  • NPI 1992877278
  NPD (past) Authorized official

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193011200000",
    "number": "1437273083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "738 W NORTHWEST HWY",
            "city": "BARRINGTON",
            "state": "IL",
            "postal_code": "600102640",
            "telephone_number": "847-382-5111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "183 HERITAGE DR",
            "city": "CRYSTAL LAKE",
            "state": "IL",
            "postal_code": "600148042",
            "telephone_number": "815-455-4434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DERMATOLOGY CENTERS, SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2007-10-22",
        "status": "A",
        "authorized_official_last_name": "VAN DAM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-382-5111",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delight in Living, LTD
• Katherine Delli Paoli, MS, OTR/L
• Katherine Z Demunno, OTR/L
• Dental Office 300 Memorial Drive LLC
• Derick Dermatology, PLLC
• Kathleen Mary Deroche, LCSW
• Christina M Deroo, MOT, OTR/L
• Donna Lynn Derose, APN
• Nikul Desai, DPT
• Ali M Dia, D.C.

• Dermatology Physician in Crystal Lake, IL
• Providers in Crystal Lake, 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 22, 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.