North Suburban Dermatology Associates,SC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

NORTH SUBURBAN DERMATOLOGY ASSOCIATES,SC

Practice address

1O3 S Greenleaf St
Suite J
Gurnee, IL 60031-3370

Phone

(847) 662-8201

Fax

(847) 662-8215

NPI assigned

May 16, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Samuel Solomon, M.D.

Title

President

Phone

(847) 662-8201

Specialties & licenses 1

Addresses

Other identifiers 10

Locations

Practitioners 4

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

• Laurence F Gibson, MD

  • Surgery Physician
  • Gurnee, IL
  • NPI 1710968532
  NPD (past)
• Aaron M Siegel, MD

  • Surgery Physician
  • Gurnee, IL
  • NPI 1356332860
  NPD (past)
• Paul N Strohmayer, M.D.

  • Surgery Physician
  • Gurnee, IL
  • NPI 1154312700
  NPD (past)
• James Michael Torres, M.D.

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Inverness, IL
  • NPI 1003178518
  NPD (past)

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1202774400000",
    "number": "1609827237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1O3 S GREENLEAF ST",
            "address_2": "SUITE J",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313370",
            "telephone_number": "847-662-8201",
            "fax_number": "847-662-8215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1O3 S GREENLEAF ST",
            "address_2": "SUITE J",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600313370",
            "telephone_number": "847-662-8201",
            "fax_number": "847-662-8215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SUBURBAN DERMATOLOGY ASSOCIATES,SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2008-02-12",
        "status": "A",
        "authorized_official_last_name": "SOLOMON",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-662-8201",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DUBIN NPI",
            "identifier": "1356495030",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA - SAMUEL SOLOMON",
            "identifier": "6945148002",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "O4920144",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOLOMON NPI",
            "identifier": "1558316281",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GRP",
            "identifier": "453550",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA - SAMUEL SOLOMON",
            "identifier": "4044905",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA- BENJAMIN DUBIN, MD",
            "identifier": "7248829002",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDR INVIDUAL SOLOMON",
            "identifier": "K39549",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MDR INDIVIDUAL DUBIN",
            "identifier": "K39550",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA- BENJAMIN DUBIN,MD",
            "identifier": "4392571",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lourdes N Nogoy, DENTAL HYGIENIST
• North Lake Cardiovascular Center PC
• North Shore Allergy and Asthma, S.C.
• North Shore Naprapathics
• North Shore Psychology Specialists, PC
• North Suburban Endodontics PC (Dr Kermit Radke)
• North Suburban Medical Office, LTD
• North Suburban Medical S.C.
• North Suburban Nephrology LLC
• Northern Gurnee Lab, LLC

• Specialist in Gurnee, IL
• Providers in Gurnee, IL by specialty
• Specialist in Illinois

• 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.