NPIMap

Organization Active NPI

North Shore Center for Medical Aesthetics, LTD.

  • Dermatology Physician
  • Northbrook, IL
National Provider Identifier
1508901307
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
NORTH SHORE CENTER FOR MEDICAL AESTHETICS, LTD.
Practice address
1535 Lake Cook Rd
Suite 401
Northbrook, IL 60062-1447
Phone
(847) 480-1111
NPI assigned
Feb 20, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Andrew Scheman, M.D.NPI 1881674828
Title
President
Phone
(847) 480-1111

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X IL Primary

Addresses

Primary practice location

1535 Lake Cook Rd
Suite 401
Northbrook, IL 60062-1447

Mailing address

1535 Lake Cook Rd
Suite 401
Northbrook, IL 60062-1447
Phone (847) 480-1111

Other identifiers 1

IdentifierTypeStateIssuer
01633347OtherILBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040305000668 IL Part B Supplier - Clinic/Group Practice 3072401652 Receives reassigned benefits from 13 practitioners
Practice locations: Northbrook, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D1035201North Shore Center for Medical Aesthetics1535 Lake Cook Rd, Ste 401, Northbrook, IL 60062ComplianceJul 31, 2026

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508901307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1535 LAKE COOK RD",
            "address_2": "SUITE 401",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621447",
            "telephone_number": "847-480-1111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1535 LAKE COOK RD",
            "address_2": "SUITE 401",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600621447",
            "telephone_number": "847-480-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE CENTER FOR MEDICAL AESTHETICS, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHEMAN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-480-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01633347",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Northbrook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.