Oak Dermatology LLC

Primary specialty

MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X

Legal business name

OAK DERMATOLOGY LLC

Practice address

550 E Devon Ave Ste 200
Itasca, IL 60143-2639

Phone

(864) 625-3376

Fax

(855) 792-2250

NPI assigned

Nov 30, 2017

Last updated

Oct 11, 2018By 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

Ashish Bhatia, MDNPI 1073595690

Title

Part Owner

Phone

(864) 625-3376

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 31

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.

• Ashish C Bhatia, M.D.

  • Procedural Dermatology Physician
  • Itasca, IL
  • NPI 1073595690

  Mohs-Micrographic Surgery

  Medicare reassignment Care Compare group NPD Authorized official
• Nour Al-Hadidi, MD

  • Dermatology Physician
  • Itasca, IL
  • NPI 1285014860
  Medicare reassignment Care Compare group NPD
• Kyle Raj Bhatia, MD

  • Dermatology Physician
  • Itasca, IL
  • NPI 1942838289
  Medicare reassignment Care Compare group NPD
• Joseph Daw Jr., MD, DDS

  • Plastic and Reconstructive Surgery Physician
  • Itasca, IL
  • NPI 1982679015
  Medicare reassignment Care Compare group NPD
• Sharon Fang, MD

  • Dermatology Physician
  • Hinsdale, IL
  • NPI 1821063223
  Medicare reassignment Care Compare group NPD
• Te Shao Hsu, MD

  • Dermatology Physician
  • Itasca, IL
  • NPI 1255300042
  Medicare reassignment Care Compare group NPD
• Anthony M Janiga, M.D.

  • Dermatology Physician
  • Naperville, IL
  • NPI 1992884167
  Medicare reassignment Care Compare group NPD
• Eugen Catalin Minca, MD

  • Dermatopathology (Pathology) Physician
  • Naperville, IL
  • NPI 1861790362
  Medicare reassignment Care Compare group NPD
• Emily Erin Schnurstein, APN

  • Family Nurse Practitioner
  • Naperville, IL
  • NPI 1487167839
  Medicare reassignment Care Compare group NPD
• Mikaela Shapiro, PA-C

  • Physician Assistant
  • Plainfield, IL
  • NPI 1497587414
  Medicare reassignment Care Compare group NPD
• Rachel Sulfridge

  • Family Nurse Practitioner
  • Naperville, IL
  • NPI 1144951989
  Medicare reassignment Care Compare group NPD
• Timothy Robert Wysozan, MD

  • Dermatopathology (Pathology) Physician
  • Naperville, IL
  • NPI 1992202717
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1512000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1539216000000",
    "number": "1487168258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2496 STONEHENGE DR",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605024702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E DEVON AVE STE 200",
            "city": "ITASCA",
            "state": "IL",
            "postal_code": "601432639",
            "telephone_number": "864-625-3376",
            "fax_number": "855-792-2250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2496 Stonehenge Dr",
            "address_purpose": "LOCATION",
            "city": "Aurora",
            "state": "IL",
            "postal_code": "605024702",
            "country_code": "US",
            "telephone_number": "330-324-6200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3100 Theodore St Ste 202",
            "address_purpose": "LOCATION",
            "city": "Joliet",
            "state": "IL",
            "postal_code": "604350605",
            "country_code": "US",
            "telephone_number": "864-625-3376",
            "fax_number": "855-792-2250",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "OAK DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-30",
        "last_updated": "2018-10-11",
        "status": "A",
        "authorized_official_last_name": "BHATIA",
        "authorized_official_first_name": "ASHISH",
        "authorized_official_title_or_position": "PART OWNER",
        "authorized_official_telephone_number": "864-625-3376",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• MOHS-Micrographic Surgery Physician in Itasca, IL
• Providers in Itasca, IL by specialty
• MOHS-Micrographic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2018; 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.