West Suburban Dermatology & Cosmetic Surgery

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036108686 Issued in IL

Legal business name

WEST SUBURBAN DERMATOLOGY & COSMETIC SURGERY

Practice address

2560 Foxfield Rd
Suite 100
Saint Charles, IL 60174-5797

Phone

(630) 443-8855

Fax

(630) 443-8866

NPI assigned

Dec 19, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Erin M. Daniels

Title

Practice Manager

Phone

(630) 443-8855

Specialties & licenses 1

Addresses

Other names 1

• Clear Skin Dermatology Doing business as

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.

• Laurence Martin Bradley Jr., M.D.

  • Dermatology Physician
  • Algonquin, IL
  • NPI 1639516313
  Medicare reassignment Care Compare group NPD
• Rany Jazayerli, M.D.

  • Dermatology Physician
  • Saint Charles, IL
  • NPI 1831197995
  Medicare reassignment Care Compare group NPD
• Seema Pasha Apichai, M.D.

  • Anatomic Pathology Physician
  • Chicago, IL
  • NPI 1811204399
  Medicare reassignment Care Compare group
• Jennifer Cunningham, PA

  • Physician Assistant
  • Aurora, IL
  • NPI 1275644817
  Medicare reassignment Care Compare group
• Sarah Lupa, MS, PA-C

  • Medical Physician Assistant
  • Oak Park, IL
  • NPI 1144659392
  Medicare reassignment Care Compare group
• Joseph A Franco, M.D.

  • Plastic Surgery Physician
  • Oak Park, IL
  • NPI 1750324257
  Medicare reassignment NPD
• Adam G Levin

  • Dermatology Physician
  • Wauseon, OH
  • NPI 1952862468

  IL

  Medicare reassignment NPD
• Vasantha L Gona, M.D.

  • Internal Medicine Physician
  • Sycamore, IL
  • NPI 1114983798
  NPD (past)

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376438400000",
    "number": "1477617207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2560 FOXFIELD RD",
            "address_2": "SUITE 100",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601745797",
            "telephone_number": "630-443-8855",
            "fax_number": "630-443-8866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2560 FOXFIELD RD",
            "address_2": "SUITE 100",
            "city": "SAINT CHARLES",
            "state": "IL",
            "postal_code": "601745797",
            "telephone_number": "630-443-8855",
            "fax_number": "630-443-8866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST SUBURBAN DERMATOLOGY & COSMETIC SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2013-08-14",
        "status": "A",
        "authorized_official_last_name": "DANIELS",
        "authorized_official_first_name": "ERIN",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "630-443-8855",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036108686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clear Skin Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda B. Wendel, M.D.
• Lucas J Wendel, M.D.
• Carolyn I Werneke, PSY.D.
• Dana Michele Werner, ED.S., MSW, LSW
• Amy Wessel
• John Jacob Wett, M.S., LMFT
• Daniel Wheeler, DPT
• White Oak Family Wellness, SC
• Brian A White
• Cecile Marie White, SLP

• Dermatology Physician in Saint Charles, IL
• Providers in Saint Charles, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; 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.