Individual provider Active NPI

Quenby Lea Erickson, D.O

  • Dermatology Physician
  • Chicago, IL
National Provider Identifier
1558356410
Registry record updated Aug 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
02002378A Issued in IN
Practice address
737 N Michigan Ave Ste 900
Chicago, IL 60611-6600
Phone
(312) 300-6858
NPI assigned
Sep 16, 2005
Last updated
Aug 7, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 02002378A IN Primary
MOHS-Micrographic Surgery Physician 207ND0101X 036-114774 IL

Addresses

Primary practice location

737 N Michigan Ave Ste 900
Chicago, IL 60611-6600

Mailing address

737 N Michigan Ave Ste 900
Chicago, IL 60611-6600
Phone (312) 300-6858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060207000991 IL Practitioner - DermatologyPractitioner - Micrographic Dermatologic Surgery (MDS) 8022023316 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
02002378AINMDDermatology Physician
036-114774ILMDMOHS-Micrographic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Suleman J. Bangash D.O.S.C. Mohs-Micrographic Surgery CurrentSince Feb 24, 2015 Accepting new patients
Mohs Surgery &Dermatology PastSince Feb 24, 2015 Accepting new patients
Physicians Dermpath Laboratory Past Accepting new patients
Distinctive Dermatologyltd Dermatology PastSince Sep 1, 1997 Accepting new patients

Locations

820 E Terra Cotta Ave
Ste 125
Crystal Lake, IL 60014
Phone (815) 455-4434

1750 N Randall Rd
Ste 120
Elgin, IL 60123
Phone (847) 608-6647

Interoperability endpoints

  • Direct secure messaging: qerickson@illinois.emadirect.md

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1126828800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754524800000",
    "number": "1558356410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "737 N MICHIGAN AVE STE 900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606116600",
            "telephone_number": "312-300-6858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "737 N MICHIGAN AVE STE 900",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606116600",
            "telephone_number": "312-300-6858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERICKSON",
        "first_name": "QUENBY",
        "middle_name": "LEA",
        "name_prefix": "Dr.",
        "credential": "D.O",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-16",
        "last_updated": "2025-08-07",
        "certification_date": "2025-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IN",
            "license": "02002378A",
            "primary": true
        },
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "IL",
            "license": "036-114774",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.