Dy Dermatology, LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

DY DERMATOLOGY, LLC

Practice address

1452 Waukegan Rd
Glenview, IL 60025-2121

Phone

(847) 832-1185

Fax

(847) 730-3617

NPI assigned

Dec 1, 2015

Organization subpart

No

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

Authorized official

Name

Lady C. DyNPI 1467462929

Title

MD

Phone

(847) 832-1185

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

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

CLIA laboratory certificates

Locations

Practitioners 2

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

• Lady C Dy, MD

  • Dermatology Physician
  • Glenview, IL
  • NPI 1467462929
  Medicare reassignment NPD Authorized official
• Gina Marie Stone, PA-C

  • Physician Assistant
  • Glenview, IL
  • NPI 1629675186
  Medicare reassignment

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

{
    "created_epoch": "1448928000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456704000000",
    "number": "1629443759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1452 WAUKEGAN RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600252121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1452 WAUKEGAN RD",
            "city": "GLENVIEW",
            "state": "IL",
            "postal_code": "600252121",
            "telephone_number": "847-832-1185",
            "fax_number": "847-730-3617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DY DERMATOLOGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-01",
        "last_updated": "2016-02-29",
        "status": "A",
        "authorized_official_last_name": "DY",
        "authorized_official_first_name": "LADY",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "847-832-1185"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Ann Duncan, OTR/L
• Gina Marguerite Dunkin, P.T.
• Rachel Dunn, PT
• Trevor Wayne Dunn
• Filangelo D Duque, PT
• Lady C Dy, MD
• Danielle Dyball
• Michael Dyme
• Diane Dynes, PTA
• Jane V Dyonzak, PH.D.

• Dermatology Physician in Glenview, IL
• Providers in Glenview, IL by specialty
• Dermatology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; 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.