Center for Dermatology and Aesthetic Medicine, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036139965 Issued in IL

Legal business name

CENTER FOR DERMATOLOGY AND AESTHETIC MEDICINE, LLC

Practice address

755 N Wells St
Suite 201
Chicago, IL 60654-3520

Phone

(312) 380-6747

Fax

(312) 348-7229

NPI assigned

Jun 30, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Faiyaaz Ahmad Kalimullah, M.D.NPI 1063729895

Title

Director

Phone

(312) 380-6747

Specialties & licenses 1

Addresses

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 2

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

• Faiyaaz Ahmad Kalimullah, M.D.

  • Dermatology Physician
  • Chicago, IL
  • NPI 1063729895
  Medicare reassignment Care Compare group NPD Authorized official
• Kevin Patrick Cavanaugh, MD

  • Dermatology Physician
  • Chicago, IL
  • NPI 1184938284
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1467244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467244800000",
    "number": "1447601414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 N WELLS ST",
            "address_2": "SUITE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543520",
            "telephone_number": "312-380-6747",
            "fax_number": "312-348-7229"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 N WELLS ST",
            "address_2": "SUITE 201",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543520",
            "telephone_number": "312-380-6747",
            "fax_number": "312-348-7229"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTER FOR DERMATOLOGY AND AESTHETIC MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A",
        "authorized_official_last_name": "KALIMULLAH",
        "authorized_official_first_name": "FAIYAAZ",
        "authorized_official_middle_name": "AHMAD",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "312-380-6747",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036139965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Center for Behavioral Medicine
• Center for Behavioral Medicine LTD
• Center for Behavioral Medicine, LTD
• Center for Community and Psychotherapy
• Center for Comprehensive Neurobehavioral Care
• Center for Functional Rehabilitation
• Center for Grief Recovery and Sibling Loss
• Center for Gynecology and Cosmetics, LTD
• Center for Housing and Health
• Center for Integrative Psychiatry LLC

• 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 Jun 30, 2016; 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.