Organization Active NPI

Stees Dermatology SC

  • MOHS-Micrographic Surgery Physician
  • Dixon, IL
National Provider Identifier
1487361218
Registry record updated Nov 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
Legal business name
STEES DERMATOLOGY SC
Practice address
215 E 1St St Ste 305
Dixon, IL 61021-3190
Phone
(815) 285-5484
Fax
(815) 285-5486
NPI assigned
Nov 1, 2022
Last updated
Nov 1, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2022

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

Authorized official

Name
Dr. Marc A Stees, MDNPI 1356430458
Title
Owner
Phone
(815) 285-5484

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X NU
MOHS-Micrographic Surgery Physician 207ND0101X NU Primary

Addresses

Primary practice location

215 E 1St St Ste 305
Dixon, IL 61021-3190

Mailing address

215 E 1St St Ste 305
Dixon, IL 61021-3190
Phone (815) 285-5484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221128002738 IL Part B Supplier - Clinic/Group Practice 2062880891 Receives reassigned benefits from 1 practitioner
Practice locations: Dixon, IL

National Provider Directory

National Provider Directory

Locations

215 E 1st St
Ste 305
Dixon, IL 61021
Phone (815) 285-5484

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1667260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667260800000",
    "number": "1487361218",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 E 1ST ST STE 305",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213190",
            "telephone_number": "815-285-5484",
            "fax_number": "815-285-5486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 E 1ST ST STE 305",
            "city": "DIXON",
            "state": "IL",
            "postal_code": "610213190",
            "telephone_number": "815-285-5484",
            "fax_number": "815-285-5486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEES DERMATOLOGY SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-01",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A",
        "authorized_official_last_name": "STEES",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-285-5484",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dixon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.