Organization Active NPI

Strow Dermatology LTD

  • Medical Specialty Clinic/Center
  • Springfield, IL
National Provider Identifier
1497930689
Registry record updated Feb 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
STROW DERMATOLOGY LTD
Practice address
2041 W Iles Ave
Springfield, IL 62704-7005
Phone
(217) 793-5517
NPI assigned
Jan 7, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2008

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

Authorized official

Name
M Elizabeth Strow
Title
MD
Phone
(217) 793-5517

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X IL Primary

Addresses

Primary practice location

2041 W Iles Ave
Springfield, IL 62704-7005

Mailing address

2041 W Iles Ave
Springfield, IL 62704-7005
Phone (217) 793-5517

Other identifiers 1

IdentifierTypeStateIssuer
779860OtherILPROVIDER NUMBER

National Provider Directory

National Provider Directory

Locations

2041 W Iles Ave
Springfield, IL 62704
Phone (217) 793-5517

NPI Registry JSON

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

{
    "created_epoch": "1199664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1497930689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2041 W ILES AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047005",
            "telephone_number": "217-793-5517"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2041 W ILES AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627047005",
            "telephone_number": "217-793-5517"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STROW DERMATOLOGY LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-07",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "STROW",
        "authorized_official_first_name": "M ELIZABETH",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "217-793-5517"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER NUMBER",
            "identifier": "779860",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.