Millennium Park Dermatology, S.C.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

036106254 Issued in IL

Legal business name

MILLENNIUM PARK DERMATOLOGY, S.C.

Practice address

30 N Michigan Ave
Suite 1429
Chicago, IL 60602-3402

Phone

(312) 407-0000

Fax

(312) 407-0001

NPI assigned

Sep 1, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Victoria Barbosa, M.D.

Title

Physician Owner

Phone

(312) 407-0000

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1283299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283299200000",
    "number": "1649587395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE",
            "address_2": "SUITE 1429",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023402",
            "telephone_number": "312-407-0000",
            "fax_number": "312-407-0001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MICHIGAN AVE",
            "address_2": "SUITE 1429",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606023402",
            "telephone_number": "312-407-0000",
            "fax_number": "312-407-0001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILLENNIUM PARK DERMATOLOGY, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-01",
        "last_updated": "2010-09-01",
        "status": "A",
        "authorized_official_last_name": "BARBOSA",
        "authorized_official_first_name": "VICTORIA",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "312-407-0000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036106254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Millenium Wellness Center, S.C.
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• Millennium Behavior Health Services
• Millennium Dental Specialist
• Millennium Medical Group, LLC
• Millennium Park Medical Associates, S.C.
• Millennium Park Psychological Associates, LLC
• Millennium Park Smiles, LLC
• Millennium Surgical, Inc
• Millenova

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2010; 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.